儿童脓毒症急性肾损伤与液体管理

Liquid treatment in children with acute kidney injury induced by sepsis

脓毒症是儿童急性肾损伤（AKI）的主要病因，为脓毒症死亡的独立危险因素。液体复苏是脓毒症及AKI救治最重要的治疗措施之一，但过量输液导致液体超负荷会加重患者的AKI，不同阶段应采用不同的液体治疗策略，早期充分液体复苏，后期限制性液体治疗。开展动态的、无创的血流动力学监测是危重症AKI患者液体管理的最佳方法。

Acute kidney injury（AKI） is a clinical critical syndrome caused by a variety reason, sepsis is the leading cause and independently associated with mortality in critical patients. Fluid resuscitation is one of the most im- portant treatment of spesis and AKI. Fluid overload has been shown to be associated with worse outcomes in critically ill patients. Different liquid treatment should be adopted in different stages. To carry out dynamic, noninvasive hemodynamic monitoring is the best way to critical patients with AKI liquid management.