关键词: 围手术期, 液体治疗, 循环容量状态, 组织灌注

Abstract:

Clinical assessment before fluid therapy in surgical patients        DU Bin，WENG Li，YANG Xiao-bo. Department of Medical ICU, Peking Union Medical College Hospital，Beijing 100730，China
Corresponding author：DU Bin，E-mail：dubin98@gmail.com
Abstract    Fluid therapy is crucial to the perioperative management in surgical patients. Recent studies have demonstrated that perioperative fluid overload，which was considered as inevitable and harmless，is associated with poor clinical outcome. Patient history，signs/symptoms，laboratory findings，and static hemodynamic parameters are not helpful to predict fluid status and/or volume status in perioperative surgical patients. Fluid challenge and dynamic hemodynamic parameters might provide valuable information of fluid responsiveness. Both crystalloids and colloids may increase cardiac preload，with different infused volume and distinct adverse effects. Type and dose of intravenous fluids must be decided based on clinical assessment of individual patient，including volume status，renal function, coagulopathy，and pulmonary edema. The objective of fluid management is to improve tissue perfusion and organ dysfunction，avoiding side effects of fluid therapy.

Key words: perioperative period, fluid therapy, volume status, tissue perfusion