Fluid Management and Transfusion.

Estimates suggest that over half of critically ill patients receive fluid resuscitation early in the course of their illness; however, volumes and types of fluid vary substantially. Moreover, the association between overzealous fluid administration and numerous deleterious outcomes across variable patient populations has challenged the traditional reflexive instinct that fluids are the answer to all hemodynamic perturbations. Similarly, equivalent outcomes among anemic patients managed with either restrictive or liberal transfusion strategies has led to the growing adoption of the former. Clinicians must, however, reconcile this trend with the established roles of blood component therapy early in the course of resuscitation following hemorrhagic shock and in the prevention and treatment of coagulopathy.