重症患者液体复苏:种类选择的辛路历程

Fluid resuscitation for critical illness: the heated debate in type of fluids

晶体液和胶体液在容量复苏中的作用之争已逾一个世纪。毫无疑问,晶体液是最为普遍的临床应用液体种类,而胶体液却具有高效扩充容量的优势。然而,对于机体存在复杂病理生理变化的重症患者,胶体液与晶体液各自所发挥的有益效应与可能引起的有害作用优劣的比较至今仍无结论。文章通过回顾人们对不同液体种类应用于重症患者容量复苏的认知历程,探讨液体种类选择的有效性与安全性问题。

A heated debate on the role of crystalloids vs colloids in resuscitation of critical illness continued over a century. It was the fact that crystalloids were the predominantly used fluids while colloids were characterized with high efficacy on replacement of plasma volume. Meanwhile, it remained inconclusive whether one was superior to another type of fluid providing more beneficial than harmful effects for critical ill patients who were characterized with complex pathophysiological abnormalities. This article was aimed at discussing efficacy vs safety between crystalloids and colloids through reviewing history of approaches promotion on options of type of fluids for resuscitation in critical ill patients.