【正文】
mful in critical illness。,液體(y232。)兩組比較,第十頁,共三十九頁。ir243。ngr233。tǐ)復(fù)蘇,第六頁,共三十九頁。ir243。,液體復(fù)蘇目標(biāo):最佳心室(xīnsh236。ng) 心室舒張壓下降,每搏輸出量下降 心輸出量下降,組織灌注不足,第三頁,共三十九頁。,1.液體(y232。ng)or限制?,中南大學(xué)湘雅醫(yī)院中心(zhōngxīn)ICU 徐道妙,第一頁,共三十九頁。,內(nèi)容(n232。tǐ)復(fù)蘇—,有效(yǒuxi224。,1.液體(y232。)舒張末容積——最佳收縮力SV、CO、DO2增加——改善組織灌注。ng)概要,第五頁,共三十九頁。,失血性休克液體(y232。n),努力盡早、盡快地充分進行液體復(fù)蘇 ,恢復(fù)有效血容量和使血壓恢復(fù)至正常水平 ,以保證臟器和組織的灌注 ,阻止休克的進一步發(fā)展。ng)概要,第八頁,共三十九頁。,早期開放性液體(y232。tǐ)復(fù)蘇:The more,the better?NO!,“O Lord, methought what pain it was to drown,what dreadful noise of waters in my ears! What sights of ugly death within my eyes!” 天哪,天哪!我好像深感淹沒水中之苦;浪濤聲在耳朵邊想著,十分(sh237。 Unnecessary fluid (ie, fluid that does notenhance perfusion) will cause or exacerbate edema in lungs, heart, gut, skin,brain, and other tissues. At times, this creates clinically obvious organ failure, such as respiratory failure, abdominal compartment syndrome, or cerebral