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Effects of fluid administration on
enal perfusion in critically ill patients
危重病人液体管理对肾灌注的影响
Contents
Introduction
Methods
Results
Conclusions
Introduction
oxygen demand
oxygen delivery
Imbalance
Imbalance in oxygen delivery and oxygen demand is
common in critically ill patients, especially those with
acute circulatory failure of septic, hypovolemic or
cardiogenic origin
Introduction
acute kidney injury(akd) is a frequent complication of
circulatory failure and associated with increased morbidit
and mortality
·急性肾损伤是循环衰竭状态下的常见并发症,它与发
病率及死亡率的升高密切相关。
Introduction
Fluid resuscitation is a first-line therapy used to restore
oxygen delivery to the organs and prevent AKI and yet
the renal effects of fluid resuscitation are not easily
assessed
·液体复苏是恢复器官血氧输送及预防AKI的一线治
疗方法,然而液体复苏对于肾脏的影响是不容易评
估的
Introduction
Physicians generally evaluate the effectiveness of fluid therapy by looking at
systemic hemodynamic variables, such as mean arterial pressure(MAP)or
cardiac output, because the increase in urine output may be delayed or inconsistent
and the decrease in serum creatinine may be even slower. A direct evaluation of
renal hemodynamics would be valuable
医师通常通过全身血流动力学变量来评估液体治疗的效果,比
如:平均动脉压、心输出量,因为尿量增加可能会延迟或者与
实际情况不—致,血肌酐的下降也非常慢,这些指标都不能及
时有效的反应肾灌注情况
·一种可以直接评估肾脏血流动力学的方法将非常有价值。
Introduction
We used Doppler techniques to investigate the effects of fluid
administration on intrarenal hemodynamics and the relationship
between changes in renal hemodynamics and urine output.
·我们用多普勒技术研究液体管理对肾內血流动力学的影响以及
肾脏血流动力学与尿量的关系。
Measurement 1
Measurement 2
UO/3H
UO/3H
Intervention
End of intervention
Fig. I Summary of the study design. The intervention was a fluid challenge that
consisted of infusion of a minimum volume of 500 ml at a minimum rate of 1 000
nl/hour. Interlobar artery Doppler variables, blood pressure, heart rate and
urine output were recorded before and after the fluid challenge and stabilization of
hemodynamic variables. UO/3H: urine output volumes measured over 3 hours
肾
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