COVID-19患者的自由与保守液体治疗:治疗危重患者的最佳策略是什么?

Jose Bohorquez-Rivero, E. García-Ballestas, Tariq Janjua, L. Moscote-Salazar
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引用次数: 0

摘要

引起肺水肿的液体渗出;这反过来又导致肺泡气体交换紊乱。[13]这样,由于COVID - 19危重患者的肺水肿,过度的液体治疗和COVID - 19患者的正液体平衡也可能由于肺毛细血管泄漏而增加血管外肺水,这影响了气体交换,导致预后更差。[14]因此,根据这一点,并考虑到在其他ARDS或败血症人群中观察到的益处,正液体平衡的后果,可能会降低给予较少液体的成本,鉴于干预措施的可行性,建议在COVID - 19危重患者中使用保守策略而不是自由液体治疗。这种保守方法可以在保证组织灌注的同时减少体液正平衡的发生[7,9,14]。
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Liberal Versus Conservative Fluid Therapy in COVID-19 Patients: What is the Best Strategy for the Treatment of Critically ill Patients?
fluid exudation causing pulmonary edema; this, in turn, leads to alveolar gas exchange disorders.[13] In this way, due to pulmonary edema in critical COVID‐19 patients, excessive fluid therapy and a positive fluid balance in COVID‐19 patients too could increase extravascular lung water due to pulmonary capillary leak and this affecting gas exchange, resulting in a worse prognosis;[14] therefore, according to this and in view of the benefit observed in other ARDS or sepsis populations, the consequences of a positive fluid balance, the possible reduction in the cost of administering less fluids, and the feasibility of the intervention, it has been suggested to use a conservative strategy over a liberal fluid therapy in critical patients with COVID‐19. This conservative approach could reduce the occurrence of a positive fluid balance while ensuring tissue perfusion.[7,9,14]
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