The fluid challenge

Excerpt

The primary goal of fluid administration is to increase cardiac output and therefore oxygen delivery by the Frank–Starling relationship, which relates stroke volume (or cardiac output) to a cardiac filling volume (Fig. 1). However, if there is no concurrent fluid loss (for example in hemorrhage), fluid administration can result in an increase in hydrostatic pressures with ensuing edema formation. Therefore, fluid administration can be associated with a potential benefit (increase in cardiac output) and a risk of harm (increase in hydrostatic pressure). Different patients, and the same patient at different times during their illness, will have different requirements to increase their oxygen delivery and will be on different parts of the Frank–Starling curve.

…