4.6 Review

The impact of fluid therapy on microcirculation and tissue oxygenation in hypovolemic patients: a review

期刊

INTENSIVE CARE MEDICINE
卷 36, 期 8, 页码 1299-1308

出版社

SPRINGER
DOI: 10.1007/s00134-010-1912-7

关键词

Volume replacement; Crystalloids; Albumin; Gelatins; Hydroxyethyl starch; Microcirculation; Tissue oxygenation; Patients

资金

  1. B. Braun (Germany)
  2. Fresenius-Kabi (Germany)
  3. Serumwerke Bernburg (Germany)
  4. Baxter (Europe)
  5. Hutchinison Technology
  6. Baxter
  7. Novartis
  8. Eli Lilly

向作者/读者索取更多资源

An optimal volume replacement strategy aims to restore systemic hemodynamics with the ultimate goals of improving organ perfusion and microcirculation for sustaining adequate tissue oxygenation. This review presents the (patho)physiological basis of hypovolemia, microcirculation, and tissue oxygenation and presents a literature review on the effects of plasma substitutes on microperfusion and oxygenation in the clinical setting. Literature review of the effects of fluid therapy on microcirculation and tissue oxygenation using PubMed search including original papers in English from 1988 to 2009. We identified a total of 14 articles dealing with the effects of different crystalloids and colloids on organ perfusion, microcirculation, and tissue oxygenation in patients. The results are divergent, but there is a general trend that colloids are superior to crystalloids in improving organ perfusion, microcirculation, and tissue oxygenation. Due to the limited number of studies and different study conditions, a meta-analysis on the effects of the volume replacement strategies on microcirculation is not possible. Improving the microcirculation by volume replacement appears to be a promising issue when treating the critically ill. The growing insights from animal experiments have to be translated into the clinical setting to identify the optimal fluid regimen for correcting hypovolemia. New techniques for monitoring microcirculation at the bedside might provide such endpoints, although these have to be validated also in the clinical setting. Whether improved microperfusion and tissue oxygenation by fluid therapy will also improve patient outcomes will have to be proven by future studies.

作者

我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。

评论

主要评分

4.6
评分不足

次要评分

新颖性
-
重要性
-
科学严谨性
-
评价这篇论文

推荐

暂无数据
暂无数据