众多动物实验论证了丙酮酸根离子具有临床常用输液中阴离子所没有的优异生物学特性，包括提高细胞缺氧耐受性、抗氧化与抗炎作用，纠正缺氧型乳酸性酸中毒及保护线粒体功能等。因此，适用于危重病的液体治疗：既避免常规液体的"复苏损伤"毒性，如0.9%氯化钠溶液导致的高氯性酸中毒和乳酸钠溶液所致的糖酵解抑制，以及二者的炎症反应等，又在扩容同时防治多器官功能衰竭，特别是保护肠道屏障功能，表明其优越性。反复动物体内实验和初步的临床试验已显示其保护器官功能和改善氧化代谢的作用，尤其是有效纠正缺氧型乳酸性酸中毒。它能在无氧或缺氧下经乳酸脱氢酶还原反应和刺激缺氧诱导因子-1α活性，保护糖酵解代谢；在缺氧下逆转受抑制的丙酮酸脱氢酶活性，促进糖的氧化代谢，加速堆积的乳酸氧化清除。无论经静脉、腹腔和口服液体复苏，丙酮酸钠溶液都能在致死性休克动物的液体治疗中发挥以上功能。本文重点讨论以上给药途径的作用。此外，它还有防治糖尿病器官并发症，如视网膜病变和一定条件下的抗肿瘤活性，显示其重大的潜在的临床应用价值和良好前景，值得深入关注。

Numerous animal studies have demonstrated that pyruvate holds superior biological properties relative to anions in traditional solutions in fluid therapy for critical illness. The beneficial characteristics include increase of hypoxia tolerance, anti-oxidative and inflammatory effects, correction of hypoxic lactic acidosis and protection of mitochondrial function. Therefore, pyruvate-enriched solutions are potentially suitable for fluids resuscitation in critical care patients to prevent "resuscitation injury" induced by traditional fluid. For example, 0.9% sodium chloride solution commonly induces hyperchloremic acidosis, sodium lactate solution may inhibit glycolysis and both can lead to systemic inflammatory reactions in clinical fluid therapy. Pyruvate in fluid therapy is not only a volume expander, but also a therapeutic agent in prevention of multi-organ, particularly intestinal barrier, dysfunction. Thus, pyruvate appears its superiority in fluid therapy. Many animal experiments in vivo and preliminary clinical trials have demonstrated that pyruvate protects organ function and improves oxidative metabolism, specially corrects hypoxic lactic acidosis. It protects glycolytic metabolism under hypoxia, even anoxia, through lactate dehydrogenase reaction and stimulation of hypoxia inducible factor-1α; it also promotes glucose oxidative metabolism under hypoxia due to its restoration of inhibited activity of pyruvate dehydrogenase, resulting in improvement of lactic clearance. The pyruvate favorable function can be achieved by intravenous, peritoneal or oral administrations in fluid therapy of fatal shock animals. These aspects were mainly reviewed in this paper. In addition, pyruvate prevents organ complications associated with diabetes, such as retinopathy, and shows anti-cancer property under some conditions. Current findings strongly demonstrate its huge potential values and promising prospects in clinical application. Further concerns and investigations are warranted.