Fluid optimization strategies in critical care patients
نویسندگان
چکیده
Abstract Introduction Fluid optimization is an important feature in haemodynamic resuscitation. Despite recent advances, fluid management in clinical practice remains sometimes highly empirical. Well-defined endpoints of resuscitation, not only global but also focused on the microcirculatory level, as well as the correct timing for fluids administration, always according to any of the available parameters to asses fluid-responsiveness, are the essential points in order to optimize resuscitation with fluids avoiding deleterious effects. The aim of this paper is to discuss fluid optimization strategies in critical care patients. Conclusion Fluid management is a key feature in the haemodynamic resuscitation of critically ill patients and its optimization is important for a patient’s outcome.
منابع مشابه
How to avoid fluid overload.
PURPOSE OF REVIEW This review highlights the recent evidence describing the outcomes associated with fluid overload in critically ill patients and provides an overview of fluid management strategies aimed at preventing fluid overload during the resuscitation of patients with shock. RECENT FINDINGS Fluid overload is a common complication of fluid resuscitation and is associated with increased ...
متن کاملPragmatic fluid optimization in high-risk surgery patients: when pragmatism dilutes the benefits
There is increasing evidence that hemodynamic optimization by fluid loading, particularly when performed in the early phase of surgery, is beneficial in high-risk surgery patients: it leads to a reduction in postoperative complications and even to improved long-term outcome. However, it is also true that goal- directed strategies of fluid optimization focusing on cardiac output optimization hav...
متن کاملDetecting volume responsiveness and unresponsiveness in intensive care unit patients: two different problems, only one solution
Policies of fluid administration/restriction in critically ill patients have evolved over recent years. Abundant fluid resuscitation is encouraged during the early stage of severe sepsis. But a conservative fluid strategy is recommended in later stages, in particular when lungs are injured. Both strategies are risky if uncontrolled. Tests detecting volume unresponsiveness at any moment of fluid...
متن کاملAn update and review of acute kidney injury in pediatrics.
OBJECTIVES To inform the pediatric intensivist of recent advancements in acute kidney injury diagnosis and management. DATA SOURCES Studies were identified from MEDLINE (OVID), PubMed, and the Cochrane Library for topics relevant to acute kidney injury. We also reviewed bibliographies of relevant studies. DATA EXTRACTION, SYNTHESIS, AND OUTLINE REVIEW: Because of the lack of prospective trial...
متن کاملFluid management strategies in heart failure.
In patients with chronic heart failure, fluid retention (or hypervolemia) is often the stimulus for acute decompensated heart failure that requires hospitalization. The pathophysiology of fluid retention is complex and involves both hemodynamic and clinical congestion. Signs and symptoms of both hemodynamic and clinical congestion should be assessed serially during hospitalization. Core heart f...
متن کامل