容积动力学与ICU患者容量管理  

Volume dynamics and volume management in intensive care unit patients

作　　者：秦英智[1] 贺玉凝 冯全胜[1] 李智伯[1] 王志勇[1] 吴雅轩 赵静[1] 高心晶[1] Qin Yingzhi;He Yuning;Feng Quansheng;Li Zhibo;Wang Zhiyong;Wu Yaxuan;Zhao Jing;Gao Xinjing(Department of Critical Care Medicine,Tianjin Third Central Hospital,Tianjin 300170,China)

机构地区：[1]天津市第三中心医院重症医学科,天津300170

出　　处：《中华危重病急救医学》2022年第7期673-675,共3页Chinese Critical Care Medicine

摘　　要：容积动力学是在输液过程中连续多次测量血液中血红蛋白(Hb)水平, 以Hb衍生的血浆稀释度作为输入数据、尿量作为输入变量的两室组成动力学模型, 适用于麻醉、手术、脱水和低血容量患者补充晶体液。容积动力学还可以量化应力、低血容量、麻醉和手术引起的液体分布与清除的变化。影响容量复苏的伴随因素很复杂, 包括性别、年龄、血流动力学状态〔如平均动脉压(MAP)〕、健康与应激状态、肾功能、意识及手术麻醉状态等, 可影响液体的半衰期、分布和容量。本文对晶体液在体内的病理生理变化进行总结分析, 以期为危重患者的容量管理提供参考。Volume dynamics is a two-compartment dynamical model using hemoglobin(Hb)derived plasma diluted level as input data and urine output as input variable through consecutive repeated measurements of Hb concentration in the blood during infusion.It could be applied to evaluate and guide crystalloid fluid rehydration for patients with dehydration or hypovolemia and during anesthesia or surgery.Volume dynamics could be also used to quantificate of strains,hypovolume,and the change of fluid distribution and elimination caused by anesthesia or surgery.The factors which influence the volume resuscitation are complex,including gender,age,hemodynamic state[mean arterial pressure(MAP)],health and stress state,renal function,consciousness,surgical or anesthesia state and so on,which may affect the half-life,distribution,and volume of the fluid.This article summarizes and analyzes the pathophysiological changes of crystalloids fluid in vivo,in order to provide reference for volume management in critically ill patients.

关 键 词：容积动力学 两室模型 血浆容量 间质液间隙 晶体液 

分 类 号：R459.7[医药卫生—急诊医学]