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Resuscitation fluids as drugs:targeting the endothelial glycocalyx

Chinese Medical Journal 2022年第2期135卷 137-144页

作者： Guangjian Wang Hongmin Zhang Dawei Liu Xiaoting Wang Chinese Critical Ultrasound Study Group Department of Critical Care Medicine Peking Union Medical College HospitalPeking Union Medical College&Chinese Academy of Medical SciencesBeijing 100730China

fluid resuscitation is an essential intervention in critically ill patients,and its ultimate goal is to restore tissue *** illnesses are often accompanied by glycocalyx degradation caused by inflammatory reactions,hypoperfusion,shock,and so forth,leading to disturbed microcirculatory perfusion and organ ***,maintaining or even restoring the glycocalyx integrity may be of high priority in the therapeutic *** drugs,however,different resuscitation fluids may have beneficial or harmful effects on the integrity of the *** purpose of this article is to review the effects of different resuscitation fluids on the *** animal studies have shown that normal saline might be associated with glycocalyx degradation,but clinical studies have not confirmed this *** starch(HES),rather than other synthetic colloids,may restore the ***,the use of HES also leads to serious adverse events such as acute kidney injury and bleeding *** studies have suggested that albumin may restore the glycocalyx,whereas others have suggested that balanced crystalloids might aggravate glycocalyx ***,most studies did not correct the effects of the infusion rate or fluid volume;therefore,the results of using balanced crystalloids remain ***,mainly animal studies have suggested that plasma may protect and restore glycocalyx integrity,and this still requires confirmation by high-quality clinical studies.

关键词： fluid resuscitation Resuscitation fluid fluid therapy Endothelial glycocalyx Glycocalyx

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