在非心脏手术的成年人中进行液体治疗:叙述性综述
Michael Eichlseder1, Romina Schweikert2, Abdelkader Serir2
1Division of Anaesthesiology and Intensive Care Medicine 1, Medical University of Graz, Graz, Austria.
Annals of intensive care
|March 6, 2026
概括
术内流体治疗对于手术患者至关重要. 虽然平衡的晶化物和中度的基乙烯粉是安全的,但最佳的流体类型仍然不确定. 专注于液体平衡和反应能力,而不仅仅是以目标为导向的治疗,以获得更好的结果.
科学领域:
- 麻醉学 麻醉学
- 手术护理 手术护理
- 流体管理流体管理
背景情况:
- 术内流体治疗对于预防并发症至关重要.
- 当前在手术期间流体管理的实践在很大程度上不同.
- 本综述侧重于非心脏手术的成年人的流体类型,体积和策略.
研究的目的:
- 审查目前在非心脏手术的手术内流体治疗中的概念.
- 检查不同类型的液体和施用策略的安全性和有效性.
- 在外科手术期间提供关于最佳流体管理的指导.
主要方法:
- 关于手术内流体治疗的当前文献的叙述性综述.
- 分析流体类型,包括晶合物和合物.
- 评估液体管理策略,如基于计算的,液体反应和目标导向治疗.
主要成果:
- 平衡的晶体质和中等量的0.9%盐水通常是安全的.
- 中等量的基乙烯粉在手术期间似乎是安全的,尽管在重症监护中仍然存在担忧.
- 在最近的非心脏手术试验中,与常规护理相比,目标导向的流体治疗没有减少并发症.
结论:
- 最佳的手术内流体类型仍在争论中;有限量的不平衡晶化物和基乙烯粉被认为是安全的.
- 在重大非心脏手术中,通常建议轻微阳性手术内流体平衡.
- 流体响应可以指导药物的使用,但应与其他临床低血压指标相结合.
相关概念视频
Cardiac Catheterization IV: Nursing Management
922
Nursing responsibilities before cardiac catheterization include:Assess for allergies and establish baseline health status.Before cardiac catheterization, assess the patient for allergies to contrast dye. Perform a comprehensive baseline assessment, including vital signs, heart and breath sounds, and a neurovascular assessment of the extremities, noting distal pulses, skin color, and temperature. Instruct the patient to fast for 8-12 hours before the procedure. Evaluate baseline laboratory...
922
Cardiomyopathy VII: Pre and Post Operative Nursing Management
405
Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...
405
Aneurysm IV: Nursing Management
554
Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...
554
Heart Failure VI: Adjunct Therapies
488
Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.
488
Hemodialysis III: Nursing Management
1.3K
The nursing management of a patient undergoing hemodialysis includes several critical steps, starting with a thorough assessment before the procedure.Before the Hemodialysis ProcedureFirst, record the patient's vital signs—blood pressure, heart rate, respiratory rate, and temperature—to establish a baseline. This baseline is essential for detecting conditions such as hypotension that could impact the patient's response to dialysis. Document the patient's pre-dialysis weight, as this...
1.3K
Venous Thrombosis III: Interprofessional Care
431
Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
431


