液体对舌下微循环的影响:一个观点审查
Arnaldo Dubin1,2,3
1Sanatorio Otamendi, Azcuénaga 870, C1115AAB, Ciudad Autónoma de Buenos Aires, Argentina. arnaldodubin@gmail.com.
Annals of intensive care
|November 17, 2025
概括
液体复苏可能会改善休克患者的微循环,但对特定液体类型的证据是不确定的. 需要更多高质量的研究来确定增强组织输液的最佳液体.
科学领域:
- 临界护理医学 临界护理医学
- 身体生理学 身体生理学
- 血液动力学 血液动力学
背景情况:
- 液体复苏在休克时至关重要,但其微血管效应复杂,并未完全理解.
- 虽然液体可以增加心脏输出和潜在的组织输液,风险包括血液稀释和,这可能会损害微循环.
- 体溶液在理论上具有优势,但临床证据对它们对舌下微循环的影响仍然有限.
研究的目的:
- 审查生理学基础和现有证据,以检查在休克状态下注射液体对微血管的影响.
- 分析临床和实验数据关于液体复苏对舌下微循环的影响.
- 评估不同液体溶液对微循环功能的比较疗效.
主要方法:
- 对重症和手术患者的观察性和受控试验的系统审查.
- 使用视频显微镜评估液体对语言下微循环的影响的研究分析.
- 包括实验研究和临床试验,比较不同类型的流体 (例如,基乙烯粉,晶体,专).
主要成果:
- 大多数研究表明,液体复苏可以改善微循环,特别是在对液体有反应的患者中.
- 通过对比不同溶液的受控试验,由于样本规模较小和方法限制,结果不确定.
- 实验研究表明有争议的发现,一些特定解决方案的好处在临床环境中没有得到一致的复制.
结论:
- 当组织输液受到损害,心脏输出增加时,液体的使用可能会增强语言下微循环.
- 没有任何特定的液体溶液在改善微循环方面表现出明显的优势.
- 高质量的研究对于阐明各种类型的液体对舌下微循环的影响至关重要.
相关概念视频
01:17Viscosity
When water is poured into a glass, it falls freely and quickly, whereas if honey or maple syrup is poured over a pancake, it flows slowly and sticks to the surface of the container. This difference in the flow of different kinds of liquids arises due to the fluid friction between the liquid layers and the liquid and the surrounding material. This property of fluids is called fluid viscosity. In this example, water has a lower viscosity than honey and maple syrup.
The SI unit of viscosity is...
The SI unit of viscosity is...
01:19Factors Affecting Pulmonary Ventilation
Besides the pressure difference between the external environment and the lungs, the airflow rate and ease of pulmonary ventilation are also influenced by three other factors: surface tension of the fluid in the alveoli, compliance of the lungs, and airway resistance.
Alveolar Surface Tension
The alveolar fluid lines the luminal surface of the alveoli and exerts a force called surface tension. This force is caused by the polar water molecules in the liquid being more strongly attracted to each...
Alveolar Surface Tension
The alveolar fluid lines the luminal surface of the alveoli and exerts a force called surface tension. This force is caused by the polar water molecules in the liquid being more strongly attracted to each...
01:22Physiology of the Gastrointestinal System I: Ingestion and Propulsion
The physiology of the gastrointestinal system begins with ingestion as food enters the mouth.
01:26Assessment of the Mouth
A thorough mouth assessment, including inspection and palpation of the lips, gums, tongue, tonsils, uvula, and pharynx, is crucial in detecting potential health issues. Diseases ranging from oral cancer to systemic conditions like diabetes could be identified early through careful oral examination. This article provides a detailed guide on conducting a comprehensive mouth assessment.
Mouth Inspection
The inspection begins with visually examining the mouth for symmetry, color, and size.
Mouth Inspection
The inspection begins with visually examining the mouth for symmetry, color, and size.
01:25Suctioning the Oropharyngeal Airway
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...
01:27The Oral Microbiota
The oral microbiome includes a complex ecosystem comprising over 700 microbial species, identified through genomic sequencing and culture-based analyses to date. This community includes a core microbiome, found universally among individuals, and a variable component influenced by environmental factors such as diet, lifestyle, and host genetics. Site-specific conditions, including oxygen gradients, pH levels, and nutrient availability, determine the spatial distribution of these microorganisms...