在败血症周围手术患者的流体管理
Prashant Nasa1, Robert Wise2,3,4, Manu L N G Malbrain5,6,7
1Department of Critical Care Medicine and Anaesthesia, The Royal Wolverhampton NHS Trust, New Cross Hospital, Wolverhampton, UK.
Current opinion in critical care
|September 9, 2024
概括
优化败血症周围手术患者的液体复苏是关键. 个性化,以目标为导向的疗法使用平衡的解决方案可以改善结果并减少并发症.
科学领域:
- 关键护理医学 关键护理医学
- 麻醉学 麻醉学
- 外科手术的结果
背景情况:
- 术前败血症带来重大风险,流体管理是一个关键但复杂的方面.
- 缺乏和过多的水分都会对这些患者的手术和临床结果产生负面影响.
- 在麻醉和败血症期间的内皮糖 (EG) 损伤增加了血管透性,使流体管理复杂化.
研究的目的:
- 审查当前关于败血症外科手术患者流体管理的临床研究.
- 为了确定安全的液体复苏策略的知识差距.
- 通过增强理解,优化外科手术期间的结果,减少并发症.
主要方法:
- 对近期临床研究的综述 关于在败血症周围手术患者的流体管理.
- 分析影响流体运动的因素,包括麻醉类型和败血症.
- 评估不同的液体复苏策略和解决方案.
主要成果:
- 不良结果与不充分和过度的液体管理有关.
- 败血症和麻醉可能会损害内皮糖体,增加液体外流.
- 用平衡溶液 (BS) 进行个性化,目标导向的液体治疗 (GDFT) 似乎比0.9%盐水更安全,可能降低死亡率.
结论:
- 优化外科手术期间的流体管理对于败血症患者至关重要.
- 使用BS的个性化GDFT是流体复苏的推方法.
- 需要进一步研究麻醉对败血症患者EG和GDFT疗效的影响.
相关概念视频
Pneumonia V: Nursing management and Prevention
1.9K
Nursing management of pneumonia involves promoting airway patency, facilitating rest and conserving energy, encouraging fluid intake, maintaining nutrition, and educating patients.
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed....
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed....
1.9K
Endoscopic Studies II: Thoracocentesis
220
Thoracentesis(Thoracocentesis), commonly known as pleural tap, is a medical procedure where a 22 gauge needle is inserted into the pleural space, the area between the lung and chest wall. This procedure is commonly performed to diagnose or treat various respiratory disorders.
Description
Excess pleural fluid or air may accumulate in some respiratory disorders in the thoracic cavity. To treat pleural effusion, a physician conducts thoracentesis by carefully piercing the chest wall and entering...
Description
Excess pleural fluid or air may accumulate in some respiratory disorders in the thoracic cavity. To treat pleural effusion, a physician conducts thoracentesis by carefully piercing the chest wall and entering...
220
Parentral Nutrition: Centeral and Peripheral Parental Nutrition
108
Parenteral Nutrition (PN) delivers essential nutrients directly into the bloodstream, bypassing the digestive system. It is commonly used for individuals with severe digestive disorders or conditions that prevent normal nutrient absorption.
PN can be administered through two primary routes:
1. Central Parenteral Nutrition (CPN):
CPN involves delivering a high concentration of nutrients through a large vein. This is typically achieved using a Peripherally Inserted Central Catheter (PICC) or,...
PN can be administered through two primary routes:
1. Central Parenteral Nutrition (CPN):
CPN involves delivering a high concentration of nutrients through a large vein. This is typically achieved using a Peripherally Inserted Central Catheter (PICC) or,...
108
Suctioning the Nasopharyngeal Airway
309
Nasopharyngeal suctioning is a procedure to remove secretions from the upper part of the respiratory tract that the patient cannot clear independently. It helps maintain airway patency and prevents complications such as aspiration pneumonia.
Equipment Required
Equipment Required
309
Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
58
Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
58
Suctioning the Oropharyngeal Airway
185
In preparing for oropharyngeal airway suctioning, a nurse must gather all necessary equipment, including a suction unit with tubing, a prepackaged suction kit, sterile gloves, water or saline for irrigation, a water-soluble lubricant, and additional personal protective equipment (such as a gown, mask, and goggles) to control infections.
After assembling the equipment, the nurse should practice hand hygiene and don appropriate PPE according to infection control guidelines to avoid the...
After assembling the equipment, the nurse should practice hand hygiene and don appropriate PPE according to infection control guidelines to avoid the...
185


