脓毒血症合并既往心力衰竭的液体管理

Fluid Management of Sepsis with Preexisting Heart Failure

脓毒血症作为致残率和死亡率较高的疾病,治疗上液体管理环节极为重要,其中包括液体复苏。心力衰竭作为迁延反复和难以逆转的综合征,治疗则以限液为特点,降低心血管负荷。二者共病时可对机体血流动力学稳态产生严重影响,对于既往心力衰竭患者出现脓毒血症的情况,最新版相关指南并未作出与液体管理相关的规范指导,现对二者的病理内环境特点及液体管理现状进行浅析。

Sepsis is a disease with high morbidity and mortality.Fluid management is very important in treatment,including fluid resuscitation.Heart failure is a persistent and difficult to reverse syndrome,and its treatment is characterized by fluid limitation to reduce cardiovascular burden.When the two diseases coexist,it can have a serious impact on the hemodynamic stability of the body.For the sepsis of patients with preexisting heart failure,the latest version of the relevant guidelines does not make the normative guidance related to fluid management.This paper analyzes the characteristics of the pathological internal environment and the current situation of fluid management of the two.