摘要
Initial fluid resuscitation remains a cornerstone in the management of septic shock,where hypovolemia is consistently present and,if uncorrected,leads to organ hypoperfusion and dysfunction via reduced cardiac output.This hypovolemia is both absolute and relative in nature.Absolute hypovolemia arises from frequent reduced oral intake in the hours preceding hospital admission and is often compounded by external fluid losses(e.g.,vomiting,diarrhea)or internal redistribution(e.g.,third-spacing into the gastrointestinal tract).In addition,increased capillary permeability—partly due to the degradation of the endothelial glycocalyx[1]—may contribute to fluid extravasation into the interstitial space.Relative hypovolemia results from sepsis-induced vasodilation and an increase in venous capacitance,particularly within the splanchnic circulation.
