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閲覧数:127
ID 12288424
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タイトル 148th Regular Meeting of the Medical Society of Toho University Professor Special Lecture The Recent Development about Fluid Management in Patients under Surgical Stress
著者
Yoshifumi, Kotake
Department of Anesthesiology (Ohashi), School of Medicine, Faculty of Medicine, Toho University
[役割]Author
出版地 Tokyo
出版者 The Medical Society of Toho University
上位タイトル
Toho Journal of Medicine (Toho Journal of Medicine). Vol.2, No.3  (2016. 09) ,p.73- 79
識別番号
ISSN
21891990
JaLCDOI info:doi/10.14994/tohojmed.2016.r029
抄録 In this narrative review, recent development about fluid management in surgical, trauma and critically ill patients are summarized. Fluid movement across vasculature has been described by Starling principle. However, classic Starling principle may not adequately account for the clinical data and revised Starling principle has been proposed. In this revised principle, transvascular fluid movement is significantly less than previously thought and is largely dependent on hydrostatic force and healthy glycocalyx. Previously, generation of non-functioning extravascular space (third space: 3rd space) has been implicated in the generation of surgery-induced hypovolemia. However, recent investigations clearly suggest that 3rd space does not exist and question the appropriateness of supplement 3rd space loss. Actually, restrictive fluid strategy disregarding 3rd space loss achived better patient outcome. Liberal administration of normal saline has been attributed to the development of hyperchloremic metabolic acidosis but recent data demonstrate that hyperchloremia may be cause renal damage. In this perspective, use of buffered solution is advocated.
キーワード
Starling principle
third space
hyperchloremia
注記 Review Article
言語
eng
資源タイプ TOHO University Scholarly Publication
ジャンル Journal Article
著者版フラグ publisher
アクセス条件 東邦大学医学会
Index
/ Public / Toho Journal of Medicine / Vol.2 / No.3(p.73-105)
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