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BMC Anesthesiology
Published in: BMC Anesthesiology 1/2018

Open Access 01-12-2018 | Review

Choice of fluids in critically ill patients

Authors: Claude Martin, Andrea Cortegiani, Cesare Gregoretti, Ignacio Martin-Loeches, Carole Ichai, Marc Leone, Gernot Marx, Sharon Einav

Published in: BMC Anesthesiology | Issue 1/2018

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Abstract

Background

Fluids are by far the most commonly administered intravenous treatment in patient care. During critical illness, fluids are widely administered to maintain or increase cardiac output, thereby relieving overt tissue hypoperfusion and hypoxia.

Main text

Until recently, because of their excellent safety profile, fluids were not considered “medications”. However, it is now understood that intravenous fluid should be viewed as drugs. They affect the cardiovascular, renal, gastrointestinal and immune systems. Fluid administration should therefore always be accompanied by careful consideration of the risk/benefit ratio, not only of the additional volume being administered but also of the effect of its composition on the physiology of the patient. Apart from the need to constantly assess fluid responsiveness, it is also important to periodically reconsider the type of fluid being administered and the evidence regarding the relationship between specific disease states and different fluid solutions.

Conclusions

The current review presents the state of the art regarding fluid solutions and presents the existing evidence on routine fluid management of critically ill patients in specific clinical settings (sepsis, Adult Respiratory Distress Syndrome, major abdominal surgery, acute kidney injury and trauma).
Appendix
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Metadata
Title
Choice of fluids in critically ill patients
Authors
Claude Martin
Andrea Cortegiani
Cesare Gregoretti
Ignacio Martin-Loeches
Carole Ichai
Marc Leone
Gernot Marx
Sharon Einav
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Anesthesiology / Issue 1/2018
Electronic ISSN: 1471-2253
DOI
https://doi.org/10.1186/s12871-018-0669-3

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