感染性休克患者连续肾脏替代治疗中的容量管理

Volume management in continuous renal replacement therapy in patients with septic shock

感染性休克患者容易发生容量失衡,而容量失衡与重症患者器官受损和预后相关。血液净化技术是感染性休克患者常用的治疗方法之一,连续肾脏替代治疗(CRRT)可以实现目标滴定的容量管理模式,重建内环境稳态。但血液净化治疗时,临床医生在管理中通常缺少动态评估和阶段性目标。应关注感染性休克不同阶段的容量管理,全面评估容量等,最终通过CRRT实现目标导向的容量管理。

Septic shock is prone to volume imbalance,which is associated with organ damage and prognosis in severe patients.Blood purification technique is one of the commonly used treatment methods for patients with septic shock.Continuous renal replacement therapy(CRRT)can achieve a volumetric management mode of target titration and rebuild homeostasis of internal environment.However,during blood purification,clinicians usually lack dynamic assessment and phased targets in management.By focusing on the volume management at different stages of septic shock,comprehensively assessing volume,and so on,the ultimate goal oriented volume management can be achieved through CRRT.