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Fluid Resuscitation in Conditions with Increased MicrovascularPermeability


Authors: M. Matějovič;  I. Novák;  R. Rokyta Jr.;  A. Kroužecký
Authors‘ workplace: MJIP – I. interní kliniky LF UK a FN, Plzeň
Published in: Čas. Lék. čes. 2002; : 540-545
Category:

Overview

Fluid resuscitation remains a cornerstone in the treatment of various types of circulatory failure. Alterations inmicrovascular permeability are a hallmark of a number of inflammatory conditions including sepsis, septic shock,burns and the acute respiratory distress syndrome. As a result, the loss of plasma fluid into the interstitial space leadsto hypovolaemia and tissue hypoperfusion. Administration of large volumes of fluids in often necessary to restorethe nutritional blood flow to tissues. This strategy, however, involues the risk of interstitial edema formation, whichin turn may further impair tissue oxygen distribution. The presented paper briefly reviews the principles oftransvascular fluid exchange and the pathophysiology of capillary permeability. It discusses the ongoing controversyon the optimal way and the end points of volume replacement as well as the choice of fluid in conditions associatedwith capillary leakage.

Key words:
fluid resuscitation, capillary permeability, lung oedema, crystalloids, colloids, sepsis, shock, ARDS,tissue perfusion.

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Addictology Allergology and clinical immunology Angiology Audiology Clinical biochemistry Dermatology & STDs Paediatric gastroenterology Paediatric surgery Paediatric cardiology Paediatric neurology Paediatric ENT Paediatric psychiatry Paediatric rheumatology Diabetology Pharmacy Vascular surgery Pain management Dental Hygienist
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