摘要毛细血管渗漏时血管内皮细胞屏障功能受损，糖萼降解，血管通透性增加，血管内蛋白质和液体外渗至组织间隙，可同时引起血容量不足和液体过负荷。液体治疗是重要的治疗手段，现阶段仍然缺少充分证据推荐最合适的液体选择。渗漏期在充分血流动力学监测基础上，可以选择平衡盐溶液或晶体液+白蛋白或新鲜冰冻血浆，以保证有效循环血量。白蛋白或新鲜冰冻血浆特别适用于晶体液复苏失败的毛细血管渗漏综合征患儿。渗漏后期以限制性液体治疗或“去复苏”策略为主，辅以利尿剂和血液滤过（肾替代治疗/连续性肾替代治疗）协助消除液体过负荷。糖皮质激素和乌司他丁对脓毒症导致的毛细血管渗漏综合征可能有效。

abstractsCritically 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.