...
  • 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>Current opinion in anaesthesiology >Recent developments in the perioperative fluid management for the paediatric patient.
【24h】

Recent developments in the perioperative fluid management for the paediatric patient.

机译：小儿患者围手术期液体管理的最新进展。

获取原文
获取原文并翻译 | 示例
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

PURPOSE OF REVIEW: Maintenance fluid therapy represents the volume of fluids and amount of electrolytes and glucose needed to replace anticipated physiological losses from breath, sweat and urine and to prevent hypoglycaemia. For 50 years, this therapy was based on Holliday and Segar's formula, which proposed to match children's water and electrolyte requirements on a weight-based calculation using hypotonic solutions. Recent publications highlight the risk of hyponatraemia in the postoperative period and the facilitating role of a hypotonic infusion, leading some people to recommend replacing hypotonic with isotonic solutions. RECENT FINDINGS: The postoperative period is at risk for nonosmotic secretion of antidiuretic hormone, which reduces the ability of the kidneys to excrete free water. In the context of antidiuretic hormone release, the associated low urine output makes maintenance volume requirement decrease to 50% of the calculated hourly rate. While isotonic fluids are recommended during anaesthesia, controversies still exist on the nature of fluid for maintenance therapy in the postoperative period. The proof for a benefit of isotonic fluids in this context is weak; further investigations are needed to make a decision. Whatever the choice, an individualized maintenance infusion protocol for each patient is necessary. SUMMARY: As free water excretion is altered for all children in the postoperative period, it is necessary to reduce the volume of maintenance fluid therapy to half the previously recommended volume. The choice of an isotonic solution should be more pertinent to that of a hypotonic solution, but evidence is lacking for a definitive answer.
机译：审查的目的：维持性液体疗法代表补充从呼吸，汗水和尿液中预期的生理损失并预防低血糖所需的液体量以及电解质和葡萄糖的量。 50年来，这种疗法一直基于Holliday和Segar的公式，该公式提出了在使用低渗溶液进行基于体重的计算时，满足儿童对水和电解质的需求。最近的出版物强调了术后低血钠的风险以及低渗输注的促进作用，导致一些人建议用等渗溶液代替低渗。最近的发现：术后时期处于抗渗透性非利尿激素分泌的风险中，这会降低肾脏排泄游离水的能力。在抗利尿激素释放的情况下，相关的低尿量使维持量的需求降低到每小时计算量的50％。虽然建议在麻醉期间使用等渗液，但术后期间用于维持治疗的液质仍存在争议。在这种情况下，等渗液体的好处的证据很薄弱;需要进一步调查才能做出决定。无论选择什么，都需要针对每个患者的个性化维护输注方案。摘要：由于术后所有儿童的游离水排泄量都有所变化，因此有必要将维持液治疗的剂量减少到先前推荐量的一半。等渗溶液的选择应与低渗溶液的选择更为相关，但缺乏确切答案的证据。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号