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ICU液体复苏晶体及胶体.pptx

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会计学液体复苏历史回顾常用复苏液体各自特点不同液体复苏效果Humanalbuminadministrationincriticallyillpatients:systematicreviewofrandomisedcontrolledtrialsAComparisonofAlbuminandSalineforFluidResuscitationintheIntensiveCareUnitAComparisonofAlbuminandSalineforFluidResuscitationintheIntensiveCareUnit德国胶体研究权威BoldtJ涉嫌论文造假BoldtJ,HeesenM,WeltersI,etal.Doesthetypeofvolumetherapy influenceendothelial-relatedcoagulationinthecriticallyill [J]BrJAnaesth,1995,75(6):740-746.HSA无肯定疗效 BoldtJ,HeesenM,MüllerM,etal.Theeffectsofalbuminversus hydroxyethylstarchsolutiononcardiorespiratoryandcirculatory variablesincriticallyillpatients[J].AnesthAnalg,1996,83(2): 254-261.HSA无明显优点 BoldtJ,MüellerM,MengesT,etal.Influenceofdifferentvolume therapyregimensonregulatorsofthecirculationinthecritically ill[J].BrJAnaesth,1996,77(4):480-487.HSA与HES在创伤患者中相比不能降低循环黏附分子 BoldtJ,MüllerM,HeesenM,etal.Influenceofdifferentvolume therapiesonplateletfunctioninthecriticallyill[J].IntensiveCare Med,1996,22(10):1075-1081.HSA在有凝血障碍风险的患者中推荐用于一线治疗方案 BoldtJ,MüllerM,HeesenM,etal.Influenceofdifferentvolume therapiesandpentoxifyllineinfusiononcirculatingsolubleadhesion moleculesincriticallyillpatients[J].CritCareMed,1996, 24(3):385-391.HSA有减少并发症趋势 BoldtJ,MüllerM,MentgesD,etal.Volumetherapyinthecritically ill:Isthereadifference[J]?IntensiveCareMed,1998,24(1):28-36.HSA无明显优点CHEST研究肾功能影响6S研究2012SSC指南2012欧洲胶体液复苏共识3013-06-11美国FDA对羟乙基淀粉给出了黑框警告FDA给医生提出的建议CRISTAL研究欧盟增加羟乙基淀粉溶液（HES）的禁忌症Albuminversuscrystalloidsolutionsinpatientswiththeacuterespiratorydistresssyndrome:asystematicreviewandmeta-analysisRandomisedtrialsofhumanalbuminforadultswithsepsis:systematicreviewandmeta-analysiswithtrialsequentialanalysisofall-causemortality