{"id":32923,"date":"2023-05-10T00:15:31","date_gmt":"2023-05-09T17:15:31","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=32923"},"modified":"2023-05-10T16:09:44","modified_gmt":"2023-05-10T09:09:44","slug":"dich-truyen-tinh-mach-cac-nguyen-tac-su-dung","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/10\/dich-truyen-tinh-mach-cac-nguyen-tac-su-dung\/","title":{"rendered":"D\u1ecbch truy\u1ec1n t\u0129nh m\u1ea1ch: c\u00e1c nguy\u00ean t\u1eafc s\u1eed d\u1ee5ng"},"content":{"rendered":"<div>\n<div class=\"content--kLKAu baseStyles-2133108132--disableImagePointerEventOnTutorial-3958995088--anchorLinkStyles-27620709\">\n<div><strong>D\u1ecbch truy\u1ec1n t\u0129nh m\u1ea1ch\u00a0<\/strong><strong>bao g\u1ed3m d\u1ecbch truy\u1ec1n tinh th\u1ec3 v\u00e0 \u00edt d\u00f9ng h\u01a1n l\u00e0 d\u1ecbch keo. Lo\u1ea1i d\u1ecbch truy\u1ec1n, s\u1ed1 l\u01b0\u1ee3ng v\u00e0 t\u1ed1c \u0111\u1ed9 truy\u1ec1n \u0111\u01b0\u1ee3c quy\u1ebft \u0111\u1ecbnh d\u1ef1a v\u00e0o <a href=\"https:\/\/www.vinmec.com\/vi\/tin-tuc\/thong-tin-suc-khoe\/suc-khoe-tong-quat\/su-dung-dich-truyen-tinh-mach-trong-gay-me-hoi-suc\/\">ch\u1ec9 \u0111\u1ecbnh<\/a> truy\u1ec1n d\u1ecbch v\u00e0 nhu c\u1ea7u ri\u00eang bi\u1ec7t c\u1ee7a b\u1ec7nh nh\u00e2n. D\u1ecbch tinh th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 h\u1ed3i s\u1ee9c b\u1ec7nh nh\u00e2n gi\u1ea3m th\u1ec3 t\u00edch ho\u1eb7c m\u1ea5t n\u01b0\u1edbc, c\u00f2n d\u1ecbch keo \u0111\u01b0\u1ee3c d\u00f9ng cho m\u1ed9t s\u1ed1 t\u00ecnh hu\u1ed1ng \u0111\u1eb7c bi\u1ec7t nh\u01b0 c\u00e1c tr\u01b0\u1eddng h\u1ee3p n\u1eb7ng c\u00f3 gi\u1ea3m \u00e1p su\u1ea5t keo. T\u1ea5t c\u1ea3 ng\u01b0\u1eddi b\u1ec7nh n\u00ean \u0111\u01b0\u1ee3c theo d\u00f5i ch\u1eb7t ch\u1ebd k\u1ebft h\u1ee3p l\u00e2m s\u00e0ng v\u00e0 x\u00e9t nghi\u1ec7m \u0111\u1ec3 \u0111\u1ea1t m\u1ee5c ti\u00eau \u0111i\u1ec1u tr\u1ecb.<\/strong><\/div>\n<\/div>\n<h2>1. C\u00e1c lo\u1ea1i d\u1ecbch truy\u1ec1n t\u0129nh m\u1ea1ch.<\/h2>\n<h3>1.1. \u0110\u1ecbnh ngh\u0129a.<\/h3>\n<ul>\n<li><a href=\"https:\/\/www.vinmec.com\/vi\/tin-tuc\/thong-tin-suc-khoe\/suc-khoe-tong-quat\/dich-tinh-trong-hoi-suc-nhung-dieu-can-biet\/\">D\u1ecbch tinh th\u1ec3:<\/a> dung d\u1ecbch ch\u1ee9a c\u00e1c ph\u00e2n t\u1eed ch\u1ea5t tan nh\u1ecf nh\u01b0 mu\u1ed1i kho\u00e1ng, dextrose.<\/li>\n<li><a href=\"https:\/\/www.vinmec.com\/vi\/tin-tuc\/thong-tin-suc-khoe\/suc-khoe-tong-quat\/dung-dich-keo-nhung-dieu-can-biet\/\">D\u1ecbch keo:<\/a> dung d\u1ecbch ch\u1ee9a c\u00e1c ph\u00e2n t\u1eed ch\u1ea5t tan l\u1edbn nh\u01b0 albumin v\u00e0 tinh b\u1ed9t.<\/li>\n<li>D\u1ecbch truy\u1ec1n t\u0129nh m\u1ea1ch c\u00e2n b\u1eb1ng: d\u1ecbch tinh th\u1ec3 ho\u1eb7c keo kh\u00f4ng kh\u00e1c bi\u1ec7t l\u1edbn v\u1ec1 kh\u1ea3 n\u0103ng thay \u0111\u1ed5i h\u1eb1ng \u0111\u1ecbnh n\u1ed9i m\u00f4i c\u1ee7a khoang ngo\u1ea1i b\u00e0o.<\/li>\n<\/ul>\n<h3>1.2. Ph\u00e2n bi\u1ec7t osmolarity v\u1edbi tonicity c\u1ee7a d\u1ecbch truy\u1ec1n.<\/h3>\n<p>Osmolality: l\u00e0 n\u1ed3ng \u0111\u1ed9 c\u00e1c ph\u1ea7n t\u1eed ch\u1ea5t tan trong m\u1ed9t \u0111\u01a1n v\u1ecb kh\u1ed1i l\u01b0\u1ee3ng d\u1ecbch (mOsm\/kg), d\u00f9ng \u0111\u1ec3 m\u00f4 t\u1ea3 \u00e1p l\u1ef1c th\u1ea9m th\u1ea5u c\u1ee7a h\u1ec7 th\u1ed1ng sinh h\u1ecdc.<\/p>\n<p>Osmolarity: n\u1ed3ng \u0111\u1ed9 ch\u1ea5t tan trong m\u1ed9t \u0111\u01a1n v\u1ecb th\u1ec3 t\u00edch dung m\u00f4i (mOsm\/L), th\u01b0\u1eddng s\u1eed d\u1ee5ng thay th\u1ebf v\u1edbi osmolality trong th\u1ef1c h\u00e0nh l\u00e2m s\u00e0ng. \u01afu ti\u00ean d\u00f9ng m\u00f4 t\u1ea3 <a href=\"https:\/\/www.vinmec.com\/vi\/tin-tuc\/thong-tin-suc-khoe\/suc-khoe-tong-quat\/do-tham-thau-mau-la-gi\/\">\u00e1p l\u1ef1c th\u1ea9m th\u1ea5u<\/a> c\u1ee7a d\u1ecbch truy\u1ec1n t\u0129nh m\u1ea1ch. N\u00f3 t\u00ednh to\u00e1n t\u1ea5t c\u1ea3 ch\u1ea5t tan trong dung d\u1ecbch, k\u1ec3 c\u1ea3 n\u00f3 v\u00e0o \u0111\u01b0\u1ee3c t\u1ebf b\u00e0o (glucose, urea).<\/p>\n<p>Tonicity: kh\u1ea3 n\u0103ng c\u1ee7a d\u1ecbch ngo\u1ea1i b\u00e0o t\u1ea1o gradient th\u1ea9m th\u1ea5u k\u00e9o n\u01b0\u1edbc ra ho\u1eb7c v\u00e0o t\u1ebf b\u00e0o.<\/p>\n<h3>1.3. C\u00e1c lo\u1ea1i d\u1ecbch truy\u1ec1n.<\/h3>\n<\/div>\n<div class=\"css-1x17ya eyueia0\">\n<div class=\"css-1lbpfmz e1tnky2o1\">\n<div class=\"css-139mn3x e1tnky2o0\">\n<div class=\"css-hyaldf e1tnky2o1\">\n<div class=\"css-r8skn2 e1tnky2o0\">\n<div class=\"css-kb7nvz e1vkw3t42\">\n<div class=\"css-rodj39 e1tnky2o1\">\n<div class=\"css-84ablj e1tnky2o0\">\n<div class=\"css-dhmirf e1pr7vjj0\" data-variant=\"inherit\">D\u1ecbch tinh th\u1ec3 \u0111\u1eb3ng tr\u01b0\u01a1ng g\u1ed3m: NaCl 0.9%, Lactate Ringer&#8217;s.<\/div>\n<div data-variant=\"inherit\">D\u1ecbch tinh th\u1ec3 nh\u01b0\u1ee3c tr\u01b0\u01a1ng g\u1ed3m: Dextrose 5%, Dextrose 10%, NaCl 0.45%, NaCl 0.22%.<\/div>\n<div data-variant=\"inherit\">D\u1ecbch tinh th\u1ec3 \u01b0u tr\u01b0\u01a1ng: NaCl 3%, NaCl 5%.<\/div>\n<div data-variant=\"inherit\">D\u1ecbch tinh th\u1ec3 h\u1ed7n h\u1ee3p: <span id=\"Z649fd41b23a8b1f570ab83da31399cc3\" class=\"api\" data-type=\"anker\">5% dextrose trong 0.9% NaCl, 5% dextrose trong 0.45% NaCl, NaHCO3 1.3%.<\/span><\/div>\n<div data-variant=\"inherit\">Dinh tinh th\u1ec3 \u0111\u1eadm \u0111\u1eb7c: NaHCO3 8.4%, dextrose 50%.<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<div data-variant=\"inherit\"><\/div>\n<div data-variant=\"inherit\">D\u1ecbch keo g\u1ed3m:<\/div>\n<div data-variant=\"inherit\">&#8211; T\u1ef1 nhi\u00ean: albumin, huy\u1ebft t\u01b0\u01a1ng t\u01b0\u01a1i \u0111\u00f4ng l\u1ea1nh.<\/div>\n<div data-variant=\"inherit\">&#8211; Nh\u00e2n t\u1ea1o: gelatins,\u00a0dextrans,\u00a0hydroxyethyl starch.<\/div>\n<div data-variant=\"inherit\">L\u00e0m t\u0103ng th\u1ec3 t\u00edch n\u1ed9i m\u1ea1ch t\u1ed1t h\u01a1n d\u1ecbch tinh th\u1ec3, kh\u00f4ng s\u1eed d\u1ee5ng th\u01b0\u1eddng quy trong h\u1ed3i s\u1ee9c d\u1ecbch.<\/div>\n<div data-variant=\"inherit\"><\/div>\n<h2 data-variant=\"inherit\">2. \u0110\u01b0\u1eddng truy\u1ec1n cho c\u00e1c lo\u1ea1i d\u1ecbch truy\u1ec1n t\u0129nh m\u1ea1ch.<\/h2>\n<ul>\n<li>\u0110\u01b0\u1eddng t\u0129nh m\u1ea1ch ngo\u1ea1i bi\u00ean: l\u00e0 \u0111\u01b0\u1eddng th\u01b0\u1eddng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng nh\u1ea5t cho truy\u1ec1n d\u1ecbch v\u00e0\/ho\u1eb7c thu\u1ed1c.<\/li>\n<li>\u0110\u01b0\u1eddng truy\u1ec1n trong x\u01b0\u01a1ng: trong c\u00e1c tr\u01b0\u1eddng h\u1ee3p kh\u00f3 ho\u1eb7c t\u0129nh m\u1ea1ch ngo\u1ea1i bi\u00ean x\u1eb9p, \u0111\u01b0\u1eddng truy\u1ec1n trong x\u01b0\u01a1ng \u01b0u ti\u00ean h\u01a1n \u0111\u01b0\u1eddng t\u0129nh m\u1ea1ch trung t\u00e2m trong h\u1ed3i s\u1ee9c.<\/li>\n<li>\u0110\u01b0\u1eddng t\u0129nh m\u1ea1ch trung t\u00e2m: c\u00f3 th\u1ec3 l\u01b0u catheter l\u00e2u h\u01a1n \u0111\u01b0\u1eddng ngo\u1ea1i bi\u00ean v\u00e0 trong x\u01b0\u01a1ng.<\/li>\n<li>Catheter l\u00f2ng r\u1ed9ng, ng\u1eafn cho t\u1ed1c \u0111\u1ed9 ch\u1ea3y d\u1ecbch cao h\u01a1n.<\/li>\n<li>\u01afu ti\u00ean truy\u1ec1n d\u1ecbch nhanh v\u1edbi th\u1ec3 t\u00edch l\u1edbn qua nhi\u1ec1u catheter t\u0129nh m\u1ea1ch ngo\u1ea1i bi\u00ean b\u1eb1ng kim 16G tr\u1edf xu\u1ed1ng cho b\u1ec7nh nh\u00e2n s\u1ed1c gi\u1ea3m th\u1ec3 t\u00edch.<\/li>\n<\/ul>\n<div class=\"css-1x17ya eyueia0\">\n<div class=\"css-1lbpfmz e1tnky2o1\">\n<div class=\"css-139mn3x e1tnky2o0\">\n<div class=\"css-hyaldf e1tnky2o1\">\n<div class=\"css-r8skn2 e1tnky2o0\">\n<div class=\"css-kb7nvz e1vkw3t42\">\n<div class=\"css-rodj39 e1tnky2o1\">\n<div class=\"css-84ablj e1tnky2o0\">\n<div data-variant=\"inherit\">\n<h2>3. C\u00e1c nguy\u00ean l\u00fd s\u1eed d\u1ee5ng d\u1ecbch truy\u1ec1n t\u0129nh m\u1ea1ch.<\/h2>\n<h3>3.1. C\u00e1c ch\u1ec9 \u0111\u1ecbnh chung c\u1ee7a d\u1ecbch truy\u1ec1n t\u0129nh m\u1ea1ch.<\/h3>\n<p>D\u1ecbch truy\u1ec1n t\u0129nh m\u1ea1ch l\u00e0 m\u1ed9t can thi\u1ec7p th\u01b0\u1eddng d\u00f9ng nh\u1ea5t cho ng\u01b0\u1eddi b\u1ec7nh ngo\u1ea1i tr\u00fa. B\u1ec7nh nh\u00e2n c\u00f3 th\u1ec3 c\u00f3 nhi\u1ec1u ch\u1ec9 \u0111\u1ecbnh truy\u1ec1n d\u1ecbch t\u0129nh m\u1ea1ch nh\u01b0:<\/p>\n<ul>\n<li>H\u1ed3i s\u1ee9c d\u1ecbch.<\/li>\n<li>B\u00f9 d\u1ecbch:\n<ul>\n<li>Do m\u1ea5t d\u1ecbch tr\u1ef1c ti\u1ebfp ho\u1eb7c m\u1ea5t n\u01b0\u1edbc t\u1ef1 do.<\/li>\n<li><span class=\"step-2-imppact2 imppact2 usmle-gs-imppact2 step-2-condensed strongImpactHighlight--qLdOc\">Nhu c\u1ea7u d\u1ecbch c\u01a1 b\u1ea3n (d\u1ecbch truy\u1ec1n duy tr\u00ec).<\/span><\/li>\n<\/ul>\n<\/li>\n<li>\u0110i\u1ec1u ch\u1ec9nh r\u1ed1i lo\u1ea1n \u0111i\u1ec7n gi\u1ea3i (h\u1ea1 natri, h\u1ea1 kali, h\u1ea1 calci).<\/li>\n<li>Truy\u1ec1n thu\u1ed1c.<\/li>\n<\/ul>\n<h3>3.2. C\u00e1c l\u01b0u \u00fd khi ch\u1ec9 \u0111\u1ecbnh d\u1ecbch truy\u1ec1n t\u0129nh m\u1ea1ch.<\/h3>\n<ul>\n<li>D\u1ecbch truy\u1ec1n t\u0129nh m\u1ea1ch n\u00ean \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh nh\u01b0 c\u00e1c lo\u1ea1i thu\u1ed1c kh\u00e1c.<\/li>\n<li>\u0110i\u1ec1u tr\u1ecb truy\u1ec1n d\u1ecbch theo nguy\u00ean t\u1eafc 4D nh\u01b0 b\u00ean d\u01b0\u1edbi.<\/li>\n<li>B\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c truy\u1ec1n d\u1ecbch n\u00ean \u0111\u00e1nh gi\u00e1 li\u00ean t\u1ee5c (\u00edt nh\u1ea5t m\u1ed7i ng\u00e0y).<\/li>\n<li>Nguy\u00ean t\u1eafc 4D trong ch\u1ec9 \u0111\u1ecbnh d\u1ecbch truy\u1ec1n bao g\u1ed3m:<\/li>\n<\/ul>\n<ul class=\"condensed-hidden-step1\">\n<li style=\"list-style-type: none;\">\n<ul class=\"additional condensed-hidden\">\n<li>Drug: l\u1ef1a ch\u1ecdn lo\u1ea1i d\u1ecbch truy\u1ec1n ph\u00f9 h\u1ee3p.<\/li>\n<li>Dosing: t\u00ednh th\u1ec3 t\u00edch d\u1ecbch truy\u1ec1n v\u00e0 t\u1ed1c \u0111\u1ed9.<\/li>\n<li>Duration: theo d\u00f5i \u0111\u00e1p \u1ee9ng truy\u1ec1n d\u1ecbch v\u00e0 quy\u1ebft \u0111\u1ecbnh th\u1eddi gian truy\u1ec1n d\u1ecbch t\u1ed1i thi\u1ec3u &#8211; t\u1ed1i \u0111a.<\/li>\n<li>De-escalation: gi\u1ea3m li\u1ec1u v\u00e0 ti\u1ebfn t\u1edbi ng\u1eebng d\u1ecbch.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h3>3.3. C\u00e1c giai \u0111o\u1ea1n \u0111\u1ed9ng h\u1ecdc c\u1ee7a truy\u1ec1n d\u1ecbch.<\/h3>\n<ul>\n<li>Giai \u0111o\u1ea1n h\u1ed3i s\u1ee9c ng\u01b0\u1eddi b\u1ec7nh (v\u00e0i ph\u00fat): can thi\u1ec7p c\u1ee9u m\u1ea1ng b\u1ec7nh nh\u00e2n trong t\u00ecnh tr\u1ea1ng s\u1ed1c n\u1eb7ng (h\u1ed3i s\u1ee9c d\u1ecbch).<\/li>\n<li>Giai \u0111o\u1ea1n h\u1ed3i s\u1ee9c t\u1ea1ng (v\u00e0i gi\u1edd): duy tr\u00ec t\u01b0\u1edbi m\u00e1u m\u00f4 cho ng\u01b0\u1eddi b\u1ec7nh \u0111ang c\u00f3 ho\u1eb7c c\u00f3 nguy c\u01a1 r\u1ed1i lo\u1ea1n huy\u1ebft \u0111\u1ed9ng (test d\u1ecbch truy\u1ec1n, t\u0103ng li\u1ec1u d\u1ecbch duy tr\u00ec \u0111\u1ec3 gi\u1eef t\u01b0\u1edbi m\u00e1u m\u00f4).<\/li>\n<li>Giai \u0111o\u1ea1n h\u1ed3i s\u1ee9c t\u1ea1ng (v\u00e0i ng\u00e0y): qu\u1ea3n l\u00fd d\u1ecbch truy\u1ec1n \u1edf b\u1ec7nh nh\u00e2n giai \u0111o\u1ea1n \u1ed5n \u0111\u1ecbnh (d\u1ecbch truy\u1ec1n duy tr\u00ec, b\u00f9 d\u1ecbch \u0111ang m\u1ea5t) v\u00e0 d\u1ef1 ph\u00f2ng t\u00edch t\u1ee5 d\u1ecbch kh\u00f4ng c\u1ea7n thi\u1ebft (n\u00ean chuy\u1ec3n sang b\u1ed5 sung n\u01b0\u1edbc \u0111\u01b0\u1eddng mi\u1ec7ng\/\u0111\u01b0\u1eddng ru\u1ed9t).<\/li>\n<li>Giai \u0111o\u1ea1n h\u1ed3i ph\u1ee5c t\u1ea1ng (nhi\u1ec1u ng\u00e0y &#8211; nhi\u1ec1u tu\u1ea7n): gi\u1ea3m truy\u1ec1n d\u1ecbch v\u00e0 lo\u1ea1i b\u1ecf d\u1ecbch th\u1eeba.<\/li>\n<\/ul>\n<h2>4. \u0110\u00e1nh gi\u00e1 \u0111\u00e1p \u1ee9ng d\u1ecbch truy\u1ec1n v\u00e0 theo d\u00f5i.<\/h2>\n<h3>4.1. \u0110\u00e1nh gi\u00e1 l\u00e2m s\u00e0ng.<\/h3>\n<p>Bao g\u1ed3m \u0111\u00e1nh gi\u00e1 ban \u0111\u1ea7u v\u00e0 \u0111\u00e1nh gi\u00e1 l\u1ea1i t\u00ecnh tr\u1ea1ng l\u00e2m s\u00e0ng th\u01b0\u1eddng xuy\u00ean (nh\u01b0 m\u1ea1ch, huy\u1ebft \u00e1p, CRT, \u00e1p l\u1ef1c t\u0129nh m\u1ea1ch trung t\u00e2m) v\u00e0 c\u00e1c th\u00f4ng s\u1ed1 c\u1eadn l\u00e2m s\u00e0ng (c\u00e1c marker, h\u00ecnh \u1ea3nh h\u1ecdc) ph\u1ee5 thu\u1ed9c t\u00ecnh tr\u1ea1ng ng\u01b0\u1eddi b\u1ec7nh, m\u1ee5c ti\u00eau \u0111i\u1ec1u tr\u1ecb v\u00e0 \u0111\u00e1p \u1ee9ng.<\/p>\n<p>\u0110\u00e1nh gi\u00e1 gi\u1ea3m th\u1ec3 t\u00edch (m\u1ea5t d\u1ecbch) d\u1ef1a v\u00e0o:<\/p>\n<ul>\n<li>Tri\u1ec7u ch\u1ee9ng th\u1ef1c th\u1ec3 c\u1ee7a m\u1ea5t n\u01b0\u1edbc c\u00f3 bi\u1ec3u hi\u1ec7n (nh\u01b0 kh\u00f4 m\u00e0ng nh\u00e0y).<\/li>\n<li>S\u1ed1c v\u00e0 c\u00e1c d\u1ea5u hi\u1ec7u c\u1ee7a gi\u1ea3m t\u01b0\u1edbu m\u00e1u ngo\u1ea1i bi\u00ean.<\/li>\n<li>H\u1ea1 huy\u1ebft \u00e1p t\u01b0 th\u1ebf.<\/li>\n<li>Thi\u1ec3u ni\u1ec7u (c\u00f3 th\u1ec3 l\u00e0 bi\u1ec3u hi\u1ec7n c\u1ee7a t\u1ed5n th\u01b0\u01a1ng th\u1eadn c\u1ea5p tr\u01b0\u1edbc th\u1eadn).<\/li>\n<li><span class=\"nowrap\">\u2193\u00a0<span id=\"L6c0f97f18035a9ba8224d8899d699844\" class=\"api dictionary\" data-phrasegroup-id=\"PR0WMf\" data-type=\"bonus\" data-content=\"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\" data-source=\"L6c0f97f18035a9ba8224d8899d699844\">CVP<\/span><\/span>\u00a0and\u00a0<span class=\"nowrap\">\u2193\u00a0JVP<\/span><\/li>\n<li>C\u00f3 \u0111\u00e1p \u1ee9ng d\u1ecbch truy\u1ec1n.<\/li>\n<\/ul>\n<p>D\u1ea5u hi\u1ec7u nh\u1eadn bi\u1ebft ng\u01b0\u1eddi b\u1ec7nh \u0111\u1ee7 d\u1ecbch:<\/p>\n<ul>\n<li>Kh\u00f4ng c\u00f3 d\u1ea5u hi\u1ec7u gi\u1ea3m th\u1ec3 t\u00edch ho\u1eb7c t\u0103ng th\u1ec3 t\u00edch.<\/li>\n<\/ul>\n<p>D\u1ea5u hi\u1ec7u c\u1ee7a t\u0103ng th\u1ec3 t\u00edch (qu\u00e1 t\u1ea3i th\u1ec3 t\u00edch):<\/p>\n<ul>\n<li><span class=\"nowrap\">\u2191\u00a0<span id=\"L44e9b3d61d4dbd08a88cc06faa1f7a07\" class=\"api dictionary\" data-phrasegroup-id=\"PR0WMf\" data-type=\"bonus\" data-content=\"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\" data-source=\"L44e9b3d61d4dbd08a88cc06faa1f7a07\">CVP<\/span><\/span>\u00a0and\u00a0<span class=\"nowrap\">\u2191\u00a0JVP<\/span><\/li>\n<li>Ph\u00f9 ph\u1ed5i ho\u1eb7c ran \u1ea9m khi kh\u00e1m ph\u1ed5i.<\/li>\n<li>C\u1ed5 tr\u01b0\u1edbng v\u00e0\/ho\u1eb7c tr\u00e0n d\u1ecbch (tr\u00e0n d\u1ecbch m\u00e0ng ph\u1ed5i).<\/li>\n<li>T\u0129nh m\u1ea1ch c\u1ed5 n\u1ed5i.<\/li>\n<li>Ph\u00f9 chi d\u01b0\u1edbi ho\u1eb7c ph\u00f9 to\u00e0n th\u00e2n.<\/li>\n<li>T\u0103ng c\u00e2n.<\/li>\n<li>Thi\u1ec3u ni\u1ec7u ho\u1eb7c v\u00f4 ni\u1ec7u (trong t\u1ed5n th\u01b0\u01a1ng th\u1eadn c\u1ea5p t\u1ea1i th\u1eadn, sau th\u1eadn, suy tim sung huy\u1ebft).<\/li>\n<\/ul>\n<p>C\u00e1c b\u01b0\u1edbc test d\u1ecbch truy\u1ec1n:<\/p>\n<p>1. Ch\u1ecdn lo\u1ea1i d\u1ecbch.<\/p>\n<ul>\n<li><a href=\"https:\/\/www.vinmec.com\/vi\/thong-tin-duoc\/su-dung-thuoc-toan\/cong-dung-dich-truyen-ringer-lactate-500ml\/\">Lactate Ringer&#8217;s<\/a> (\u01b0u ti\u00ean trong ph\u1ea7n l\u1edbn t\u00ecnh hu\u1ed1ng).<\/li>\n<li>N\u01b0\u1edbc mu\u1ed1i sinh l\u00fd.<\/li>\n<\/ul>\n<p>2. Ch\u1ecdn t\u1ed1c \u0111\u1ed9 v\u00e0 th\u1ec3 t\u00edch truy\u1ec1n.<\/p>\n<p>Test d\u1ecbch truy\u1ec1n chu\u1ea9n:<\/p>\n<ul>\n<li>Ng\u01b0\u1eddi l\u1edbn: <span class=\"nowrap\">100\u2013200 mL<\/span> trong <span class=\"nowrap\">5\u201310 ph\u00fat<\/span> ho\u1eb7c <span class=\"nowrap\">250\u2013500 mL<\/span> trong <span class=\"nowrap\">15\u201320 ph\u00fat.<\/span><\/li>\n<li>Tr\u1ebb em: <span class=\"nowrap\">5\u201315 mL\/kg<\/span> trong <span class=\"nowrap\">5\u201310 ph\u00fat.\u00a0<\/span><\/li>\n<\/ul>\n<p>3. X\u00e1c \u0111\u1ecbnh m\u1ee5c ti\u00eau.<\/p>\n<p>D\u1ea5u hi\u1ec7u \u0111\u00e1p \u1ee9ng d\u1ecbch truy\u1ec1n.<\/p>\n<ul>\n<li><span class=\"nowrap\">T\u0103ng \u2265 10\u201315% cung l\u01b0\u1ee3ng tim ho\u1eb7c th\u1ec3 t\u00edch nh\u00e1t b\u00f3p.\u00a0<\/span><\/li>\n<li>T\u0103ng kho\u1ea3ng 12% hi\u1ec7u \u00e1p.<\/li>\n<li>C\u00e1c d\u1ea5u hi\u1ec7u sinh t\u1ed3n nh\u01b0: t\u0103ng huy\u1ebft \u00e1p t\u00e2m thu, b\u00ecnh th\u01b0\u1eddng h\u00f3a nh\u1ecbp tim v\u00e0 t\u1ea7n s\u1ed1 th\u1edf.<\/li>\n<li><span class=\"js-relevance-term step-1-imppact0 step-2-imppact0 imppact0 usmle-gs-imppact0\" data-type=\"highlight\" data-qxids=\"9P0NST;\">\u00a0Th\u1ec3 t\u00edch n\u01b0\u1edbc ti\u1ec3u<\/span><span class=\"nowrap\"><span class=\"js-relevance-term step-1-imppact0 step-2-imppact0 imppact0 usmle-gs-imppact0\" data-type=\"highlight\" data-qxids=\"9P0NST;\">\u2265 0.5 mL\/kg\/h<\/span><\/span><\/li>\n<\/ul>\n<p>4. \u0110\u1eb7t ra gi\u1edbi h\u1ea1n.<\/p>\n<ul>\n<li>Khi c\u00f3 d\u1ea5u hi\u1ec7u c\u1ee7a qu\u00e1 t\u1ea3i th\u1ec3 t\u00edch.<\/li>\n<li>C\u00e1c th\u00f4ng s\u1ed1 kh\u00e1ch quan:\u00a0\u00a0<span class=\"nowrap\">\u2191\u00a0<span id=\"L3c97d4bc261058ca1935204cd07fa2e8\" class=\"api dictionary\" data-phrasegroup-id=\"PR0WMf\" data-type=\"bonus\" data-content=\"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\" data-source=\"L3c97d4bc261058ca1935204cd07fa2e8\">CVP<\/span><\/span> t\u0103ng <span class=\"nowrap\">2 mm Hg<\/span><\/li>\n<\/ul>\n<div class=\"table-wrapper condensed-hidden api\">Ki\u1ec3m so\u00e1t c\u00e2n b\u1eb1ng d\u1ecbch. Bao g\u1ed3m nh\u1eadp, xu\u1ea5t v\u00e0 c\u1ea3 hai.<\/div>\n<div>Nh\u1eadp:<\/div>\n<div>&#8211; D\u1ecbch nu\u00f4i \u0103n \u0111\u01b0\u1eddng ru\u1ed9t.<\/div>\n<div>&#8211; D\u1ecbch nu\u00f4i \u0103n t\u0129nh m\u1ea1ch (d\u1ecbch truy\u1ec1n, thu\u1ed1c, c\u00e1c ch\u1ebf ph\u1ea9m m\u00e1u).<\/div>\n<div>&#8211; D\u1ecbch t\u1eeb c\u00e1c ch\u1ebf ph\u1ea9m thu\u1ed1c t\u0129nh m\u1ea1ch (nh\u01b0 c\u00e1c kh\u00e1ng sinh d\u1ea1ng dung d\u1ecbch).<\/div>\n<\/div>\n<div>Xu\u1ea5t:<\/div>\n<div>&#8211; M\u1ea5t qua \u0111\u01b0\u1eddng ti\u00eau h\u00f3a (ti\u00eau ch\u1ea3y, \u00f3i, d\u1eabn l\u01b0u ru\u1ed9t ho\u1eb7c d\u00f2).<\/div>\n<div>&#8211; M\u1ea5t qua \u0111\u01b0\u1eddng ni\u1ec7u (thi\u1ec3u ni\u1ec7u, v\u00f4 ni\u1ec7u, \u0111a ni\u1ec7u).<\/div>\n<div>&#8211; M\u1ea5t kh\u00f4ng nh\u1eadn bi\u1ebft.<\/div>\n<div>Nh\u1eadp v\u00e0 xu\u1ea5t: \u0111\u00e1nh gi\u00e1 c\u00e2n n\u1eb7ng h\u1eb1ng ng\u00e0y v\u00e0 v\u00f2ng b\u1ee5ng.<\/div>\n<div data-variant=\"inherit\">\n<h3>4.2. \u0110\u00e1nh gi\u00e1 b\u1eb1ng c\u1eadn l\u00e2m s\u00e0ng.<\/h3>\n<ul>\n<li>C\u00f4ng th\u1ee9c m\u00e1u (ki\u1ec3m tra c\u00f4 \u0111\u1eb7c m\u00e1u, t\u1ea7m so\u00e1t thi\u1ebfu m\u00e1u ho\u1eb7c m\u1ea5t m\u00e1u ti\u1ec1m \u1ea9n).<\/li>\n<li>H\u00f3a sinh m\u00e1u nh\u01b0 glucose, Ure, creatinine, \u0111i\u1ec7n gi\u1ea3i.<\/li>\n<li>Lactate.<\/li>\n<\/ul>\n<p>C\u00e1c c\u00f4ng c\u1ee5 h\u00ecnh \u1ea3nh h\u1ecdc \u0111\u00e1nh gi\u00e1 th\u1ec3 t\u00edch:<\/p>\n<ul>\n<li>X quang ng\u1ef1c th\u1eb3ng: ph\u00e1t hi\u1ec7n d\u1ea5u hi\u1ec7u c\u1ee7a qu\u00e1 t\u1ea3i th\u1ec3 t\u00edch.<\/li>\n<li>Si\u00eau \u00e2m tim. \u0110\u00e1nh gi\u00e1 th\u1ec3 t\u00edch t\u0129nh m\u1ea1ch v\u00e0 \u0111\u00e1p \u1ee9ng d\u1ecbch truy\u1ec1n. \u0110\u00e1nh gi\u00e1 th\u1ec3 t\u00edch d\u1ef1a v\u00e0o t\u00ednh to\u00e1n k\u00edch th\u01b0\u1edbc t\u00e2m th\u1ea5t, th\u1ec3 t\u00edch nh\u00e1t b\u00f3p, v\u00e0\/ho\u1eb7c cung l\u01b0\u1ee3ng tim.<\/li>\n<li>\u0110\u00e1nh gi\u00e1 \u0111\u00e1p \u1ee9ng d\u1ecbch truy\u1ec1n b\u1eb1ng nghi\u1ec7m ph\u00e1p n\u00e2ng ch\u00e2n th\u1ee5 \u0111\u1ed9ng, c\u00f3 th\u1ec3 \u0111\u00e1nh gi\u00e1 \u0111\u01b0\u1ee3c nguy c\u01a1 qu\u00e1 t\u1ea3i d\u1ecbch. N\u00e2ng c\u1ea3 2 ch\u00e2n\u00a045\u00b0 trong<span class=\"nowrap\"> 1 ph\u00fat, s\u1ebd l\u00e0m t\u0103ng ti\u1ec1n t\u1ea3i 150 &#8211; 300mL. \u0110\u00e1nh gi\u00e1 d\u01b0\u01a1ng t\u00ednh d\u1ef1a v\u00e0o cung l\u01b0\u1ee3ng tim v\u00e0 c\u00e1c d\u1ea5u hi\u1ec7u sinh t\u1ed3n (t\u0103ng th\u1ec3 t\u00edch nh\u00e1t b\u00f3p l\u00ean \u2265 10%).\u00a0<\/span><\/li>\n<\/ul>\n<p><strong>Ngu\u1ed3n:<\/strong><\/p>\n<p class=\"headerTitle--o3A1Z\" data-e2e-test-id=\"articleHeader\">Intravenous fluid therapy, Amboss.<\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>D\u1ecbch truy\u1ec1n t\u0129nh m\u1ea1ch\u00a0bao g\u1ed3m d\u1ecbch truy\u1ec1n tinh th\u1ec3 v\u00e0 \u00edt d\u00f9ng h\u01a1n l\u00e0 d\u1ecbch keo. Lo\u1ea1i d\u1ecbch truy\u1ec1n, s\u1ed1 l\u01b0\u1ee3ng v\u00e0 t\u1ed1c \u0111\u1ed9 truy\u1ec1n \u0111\u01b0\u1ee3c quy\u1ebft \u0111\u1ecbnh d\u1ef1a v\u00e0o ch\u1ec9 \u0111\u1ecbnh truy\u1ec1n d\u1ecbch v\u00e0 nhu c\u1ea7u ri\u00eang bi\u1ec7t c\u1ee7a b\u1ec7nh nh\u00e2n. D\u1ecbch tinh th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 h\u1ed3i s\u1ee9c b\u1ec7nh nh\u00e2n gi\u1ea3m th\u1ec3 [&hellip;]<\/p>\n","protected":false},"author":69,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[23,33],"tags":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v20.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>D\u1ecbch truy\u1ec1n t\u0129nh m\u1ea1ch: c\u00e1c nguy\u00ean t\u1eafc s\u1eed d\u1ee5ng - Vinmec<\/title>\n<meta name=\"description\" content=\"D\u1ecbch truy\u1ec1n t\u0129nh m\u1ea1ch tinh th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng ph\u1ed5 bi\u1ebfn trong l\u00e2m s\u00e0ng. 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