Applied Physiology of Fluid Resuscitation in Critical Illness

作者：Arshed Sabrina; Pinsky Michael R^*

来源：Critical Care Clinics, 2018, 34(2): 267-+.

DOI：10.1016/j.ccc.2017.12.010

• Effective circulating blood volume
• Mean systemic pressure
• Venous return
• Stressed volume
• Unstressed volume

Fluids during resuscitation from shock increase the mean systemic pressure and venous return. The pressure gradient for venous return must increase. Mean systemic pressure is the amount of vascular space in unstressed and stressed volume, mostly unstressed. Shock states can decrease the mean systemic pressure by increasing the unstressed volume, decreasing the total blood volume, or decreasing the pressure gradient for venous return. Crystalloids across bodily spaces restore normal volume, whereas colloids remain in the intravascular space. The electrolyte content of fluids matters, and excess chloride impairs renal blood flow. Albumin seems to be more effective at restoring blood volume in severe sepsis but not in other conditions.

• 出版日期2018-4