Fluid resuscitation strategy for critically ill children with capillary leakage
10.3760/cma.j.issn.1673-4912.2025.01.003
- VernacularTitle:毛细血管渗漏患儿的液体复苏策略
- Author:
Yucai ZHANG
1
;
Siqi WANG
1
;
Huijie MIAO
1
Author Information
1. 上海市儿童医院 上海交通大学医学院附属儿童医院重症医学科200062
- Publication Type:Journal Article
- Keywords:
Capillary leak syndrome;
Insufficient blood volume;
Fluid overload;
Fluid therapy
- From:
Chinese Pediatric Emergency Medicine
2025;32(1):13-17
- CountryChina
- Language:Chinese
-
Abstract:
Critically ill with capillary leakage syndrome（CLS）presents with damaged vascular endothelial cells with glycocalyx degraded,which increases vascular permeability,and leads to the protein-rich fluid from the intravascular extravasate into the interstitial space.CLS can concomitant symptoms of hypovolemia and fluid overload.Fluid therapy is the most critical element in the treatment of CLS,but still lack of sufficient evidence to guide the choice of fluid management.Based on accurately hemodynamic monitoring,balanced salt or crystalloid + albumin or fresh frozen plasma may be input to ensure effective circulating blood volume.Albumin or fresh frozen plasma is particularly suitable for CLS patients failed to respond to crystalloids during the leakage period.In the later stage of leakage,conservative fluid management with “de-resuscitation”strategy was mainly used with diuretic and hemofiltration (renal replacement therapy/continuous renal replacement therapy) for attenuating fluid overload.Steroids and ulinastatin may be effective in CLS caused by sepsis.
