| 1. Acute circulatory dysfunction can be recognized by a thorough clinical examination including assessment of the three windows of tissue perfusion—altered mentation, skin abnormalities, and oliguria—together with a combined analysis of heart rate and blood pressure | 1. 急性循环功能障碍可通过全面的临床检查识别，包括评估三大组织灌注窗口（精神状态改变、皮肤异常和少尿），并结合心率和血压的综合分析 |
| 2. Whenever possible, we recommend measuring blood lactate concentrations and integrating this information with clinical examination | 2. 我们建议尽可能测量血乳酸浓度，并将此信息与临床检查相结合 |
| 3. The purpose of fluid administration during hypovolemia is to improve tissue perfusion through increased cardiac output | 3. 在低血容量时进行液体管理的目的是通过增加心输出量来改善组织灌注 |
| 4. We suggest that, in a clinical context of hypovolemia such as bleeding, severe diarrhea, and trauma, the presence of hypotension and tachycardia or oliguria should trigger fluid administration | 4. 我们建议在出血、严重腹泻和创伤等低血容量的临床背景下，一旦出现低血压、心动过速或少尿，应启动液体管理 |
| 5. The absence of arterial hypotension does not exclude hypovolemia and the need for fluid administration | 5. 动脉低血压的缺乏并不排除低血容量和液体管理的需要 |
| 6. We recommend individualizing fluid resuscitation in all patients | 6. 我们建议对所有患者进行个性化的液体复苏 |
| 7. Fluid loading consists of rapid administration of a large amount of fluids in suspected hypovolemia | 7. 液体负荷指在疑似低血容量的情况下快速注入大量液体 |
| 8. The fluid-challenge technique is a test of the cardio-circulatory system, evaluating whether the patient has a preload reserve that can be used to increase the SV and CO with additional volume (fluid responsiveness) | 8. 液体挑战技术是对心脏循环系统的测试，评估患者是否具备前负荷储备，能够通过额外的液体量（液体反应性）来增加搏出量和心输出量 |
| 9. We recommend fluid loading in the presence of overt hypovolemia | 9. 我们建议在明显低血容量的情况下进行液体负荷 |
| 10. We recommend avoiding fluid loading in the absence of overt hypovolemia (with the exception in septic shock) | 10. 我们建议在没有明显低血容量的情况下避免液体负荷（脓毒性休克除外） |
| 11. When performing a fluid challenge, we suggest infusing 150–350 mL (or 4 mL/kg) in < 15 min | 11. 在进行液体挑战时，我们建议在不到15分钟内注入150–350 mL（或4 mL/kg） |
| 12. During fluid administration, a positive response to fluids is suggested by a marked improvement in the triggering variables | 12. 在液体管理过程中，触发变量的显著改善提示对液体的积极反应 |
| 13. When vascular tone is decreased, a lack of improvement in triggering variables (e.g. arterial BP) does not exclude a positive response to fluids | 13. 当血管张力降低时，触发变量（如动脉血压）的改善缺乏并不排除对液体的积极反应 |
| 14. The kinetics of a response in urine output to fluid administration is notoriously slow. Oliguria as a target for fluid resuscitation is problematic, since it can easily lead to fluid overload and worsening renal function | 14. 尿量对液体管理的反应动力学显著缓慢。将少尿作为液体复苏的目标是有问题的，因为这可能容易导致液体过载和肾功能恶化 |
| 15. Skin vasoconstriction can be easily assessed and monitored during fluid resuscitation | 15. 在液体复苏过程中可以轻松评估和监测皮肤血管收缩 |
| 16. We recommend that peripheral perfusion be assessed by evaluating systematic hemodynamic and other perfusion parameters and monitored during fluid resuscitation | 16. 我们建议通过评估系统性血流动力学和其他灌注参数来评估周围灌注情况，并在液体复苏过程中进行监测 |
| 17. We recommend that peripheral perfusion assessment include at least subjective evaluation of skin temperature, skin mottling, and capillary refill time | 17. 我们建议周围灌注评估至少包括对皮肤温度、皮肤斑纹和毛细血管充盈时间的主观评估 |
| 18. Jugular vein pressure alone should not be used to guide fluid administration, as its assessment with respect to treatment is complex, and this approach may lead to fluid overload | 18. 单独使用颈静脉压不应作为指导液体管理的依据，因为其与治疗相关的评估较为复杂，并且这种方法可能导致液体过载 |
| 19. A visible increase in jugular vein pressure before or during fluid loading should alert the clinician to reconsider fluid administration after a more comprehensive cardiac evaluation | 19. 在液体负荷前或过程中，如果颈静脉压显著升高，临床医生应在进行更全面的心脏评估后重新考虑液体管理 |
| 20. In elderly patients or those with arteriosclerosis or chronic arterial hypertension, a low pulse pressure (e.g. less than 40 mmHg) indicates that stroke volume is low | 20. 在老年患者或动脉硬化或慢性动脉高血压患者中，脉压低（如小于40 mmHg）提示搏出量低 |
| 21. A lack of increase in MAP does not exclude a positive response to fluid administration | 21. 平均动脉压（MAP）未增加并不排除对液体管理的积极反应 |
| 22. We suggest looking at the arterial pulse pressure changes for tracking changes in stroke volume after fluid infusion, an increase in pulse pressure being an acceptable indicator of changes in stroke volume. The absence of an increase in pulse pressure does not exclude a positive response to fluid challenge in terms of CO | 22. 我们建议通过观察动脉脉压变化来跟踪液体输注后搏出量的变化，脉压增加是搏出量变化的可接受指标。脉压未增加并不排除在心输出量方面对液体挑战的积极反应 |
| 23. In the initial resuscitation of septic shock patients, we recommend fluid loading of up to 30 ml/kg, tailored according to individual considerations such as the perceived degree of hypovolemia and potential cardiovascular risks of fluid loading | 23. 在脓毒性休克患者的初始复苏中，我们建议液体负荷可达到30 ml/kg，具体应根据个体考虑，如低血容量的程度和液体负荷的潜在心血管风险 |
| 24. The shock index might be calculated during initial assessment of acute circulatory dysfunction and could be a trigger for fluid loading | 24. 在急性循环功能障碍的初始评估中可以计算休克指数，并作为液体负荷的触发因素 |
| 25. A fluid challenge consists of the administration of a fluid bolus while evaluating its effectiveness and tolerance | 25. 液体挑战包括注入一剂液体同时评估其效果和耐受性 |
| 26. We suggest the use of crystalloids as the initial resuscitation fluid in most cases of acute circulatory failure (except when blood products are required and available) | 26. 我们建议在大多数急性循环衰竭的情况下使用晶体液作为初始复苏液体（需要和有血制品时除外） |
| 27. A concomitant increase in BP with a decrease in HR is suggestive of a positive response to fluid resuscitation | 27. 血压升高伴随心率下降提示对液体复苏的积极反应 |
| 28. We recommend against the insertion of a central line with the only purpose to measure CVP to guide fluid resuscitation | 28. 我们建议不要仅为了测量中心静脉压（CVP）而插入中心静脉导管以指导液体复苏 |
| 29. We recommend against the targeting of any specific value of CVP for fluid resuscitation | 29. 我们建议不要以任何特定的CVP值为液体复苏目标 |
| 30. If CVP is measured, a marked rise during rapid fluid administration should be interpreted to reflect poor tolerance | 30. 如果测量CVP，在快速液体管理过程中显著上升应解释为耐受性差 |
| 31. We suggest stopping fluid administration when clinical signs of fluid intolerance occur and to reassess the patient’s ongoing requirements for fluids | 31. 我们建议在出现液体不耐受的临床迹象时停止液体管理，并重新评估患者对液体的持续需求 |
| 32. We recommend that scientific communities and researchers invest in research in the field of basic fluid administration | 32. 我们建议科学界和研究人员在基础液体管理领域进行投资研究 |
| 33. We recommend a specific research focus on fluid administration in resource-limited settings | 33. 我们建议特别关注资源有限环境下的液体管理研究 |
Cecconi, M., Hernandez, G., Dunser, M. et al. Fluid administration for acute circulatory dysfunction using basic monitoring: narrative review and expert panel recommendations from an ESICM task force. Intensive Care Med 45, 21–32 (2019). https://doi.org/10.1007/s00134-018-5415-2
