脓毒性休克患儿的液体复苏策略  

Fluid resuscitation strategy for pediatric septic shock

作　　者：金萍 许峰[3] Jin Ping;Xu Feng(Department of Pediatric Intensive Care Unit,Women and Children's Medical Center(Shenzhen),Hong Kong Hub of Paediatric Excellence,the Chinese University of Hong Kong,Shenzhen 518100,China;Department of Pediatric Intensive Care Unit,Shenzhen Bao'an Maternity and Child Healthcare Hospital,Shenzhen 518100,China;Department of Critical Care Medicine,Children's Hospital of Chongqing Medical University,Chongqing 400014,China)

机构地区：[1]香港中文大学妇女儿童医学中心(深圳)PICU,518100 [2]深圳市宝安区妇幼保健院PICU,518100 [3]重庆医科大学附属儿童医院重症医学科,400014

出　　处：《中国小儿急救医学》2025年第1期8-12,共5页Chinese Pediatric Emergency Medicine

摘　　要：脓毒性休克的初始液体复苏是提高抢救成功率的重要环节。初始复苏时,首选平衡盐/缓冲晶体液。动态评估容量的SRT(Status,Responsiveness,Tolerance)原则用于优化液体管理,以避免液体过载。复苏过程中尽早使用血管活性药物可以带来多种益处。休克复苏的ROSE(Resuscitation,Optimization,Stabilization,Evacuation)策略为液体管理提供了四个动态阶段的框架,旨在确保患者在休克治疗过程中的液体平衡和安全性。床旁超声结合其他血流动力学监测指标为脓毒性休克患儿的液体复苏提供了个体化治疗可能。The initial fluid resuscitation strategies for septic shock are determined based on the availability of intensive care facilities.Balanced/buffered crystalloids are the preferred choice for the initial resuscitation of children with septic shock.The principles of volume management,known as SRT(State,Responsiveness,Tolerance),optimize fluid management and avoid fluid overload.Early initiation of vasoactive agents during resuscitation can offer multiple benefits,with epinephrine and norepinephrine serving as the first-line vasoactive infusions.The ROSE(Resuscitation,Optimization,Stabilization,Evacuation)conceptual model summarizes accurately a dynamic approach to fluid therapy,maximizing benefits and minimizing harms.Point-of-care critical ultrasound combined with other hemodynamic monitoring parameters offers the possibility of individualized treatment of children with septic shock.

关 键 词：脓毒性休克 儿童 液体复苏 

分 类 号：R47[医药卫生—护理学]