Title: Does My Patient Need More Fluids?
题目：我们的患者需要更多的液体吗？
Author作者: Haney Mallemat
葛云 译 肖锋 校

Only 50% of hemodynamically unstable patients will improve their hemodynamics in response to a fluid bolus. However, because excessive fluid administration can lead to organ edema and dysfunction, it is important to give hemodynamically unstable patients only the necessary amount of fluids to improve their hemodynamics.
只有50%血流动力学不稳的患者能通过输液来改善血流动力学。由于过度的输液可导致器官水肿和功能不全，然而，对于血流动力学不稳定的患者来说，通过一定需要量的输液来改善血流动力学又是重要的措施。
There are two general categories of assessing a patient's response to volume administration; static and dynamic assessments (see referenced article below):
一般有两种分类方法来评估患者对输液量反应；静态和动态评估(见以下相关指标)：
Static assessment (generally unreliable, but traditionally used):
静态评估（不可靠，但是还是常常使用）
Physical exam (dry mucus membranes, cool extremities, etc.)
体格检查（干燥的皮肤粘膜，湿冷的四肢末端等）
Urine output
尿量
Blood pressure
血压
Central venous pressure via central-line
通过中心静脉导管监测中心静脉炎
Dynamic assessment (more reliable but more labor intensive)
动态评估（更可靠，但需更多装置设备）
Pulse Pressure Variation
脉压差
IVC Distensibility Index
下腔静脉扩张指数
End-expiratory occlusion test
呼吸末阻塞试验
Passive Leg-Raise
被动下肢抬高
There is no simple way to accurately determine the need for a fluid bolus however the integration of the techniques above can help the clinician make better decisions.
还没有一种简单的方法来精确地确定具体液体量，但是，综合以上技术指标能帮助临床医生作出更好的决策。
References 参考文献
Napoli,A. Physiologic and Clinical Principles behind Noninvasive Resuscitation Techniques and Cardiac Output Monitoring. Cardiol Res Pract. 2012