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首页> 外文期刊>Best practice & research:Clinical anaesthesiology >Role of the glycocalyx in fluid management: Small things matter.
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Role of the glycocalyx in fluid management: Small things matter.

机译：糖萼在液体管理中的作用：小事情很重要。

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摘要

Intravenous fluid therapy and perception of volume effects are often misunderstood. The pharmacokinetical difference between colloids and crystalloids depends on the condition of the vascular permeability barrier. Its functioning is still largely based on Starling's principle from 1896, realising that transport of fluid to and from the interstitial space follows the balance between opposing oncotic and hydrostatic pressures. In the past decade, the endothelial glycocalyx, located on the luminal side of healthy vasculature, has increasingly been taken into consideration around models of transvascular fluid filtration. While crystalloids can freely pass through the glycocalyx, colloids are held back in the vasculature by this structure. This is reflected by a markedly higher intravascular persistence of isooncotic colloids (80-100%) versus crystalloids (around 20%), at least as long as the glycocalyx is intact. Protecting this structure in surgical practice means limiting the surgical trauma and avoiding intravascular hypervolemia.
机译：静脉输液治疗和对容积效应的认识常常被误解。胶体和晶体之间的药代动力学差异取决于血管通透性屏障的状况。它的功能仍主要基于1896年的Starling原理，他认识到在间隙空间之间来回流动的流体遵循相反的渗透压和静水压力之间的平衡。在过去的十年中，越来越多地在跨血管液过滤模型中考虑了位于健康脉管系统腔侧的内皮糖萼。虽然晶体可以自由地通过糖萼，但胶体却被这种结构阻止在脉管系统中。至少只要糖萼完整无缺，等渗胶体（80-100％）比晶体（约20％）的血管内持久性就明显更高。在外科手术实践中保护这种结构意味着限制外科手术创伤并避免血管内血容量过多。

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