Ten answers to key questions for fluid management in intensive care

Med Intensiva (Engl Ed). 2021 Dec;45(9):552-562. doi: 10.1016/j.medine.2020.10.006.

Abstract

This review focuses on fluid management of critically ill patients. The topic is addressed based on 10 single questions with simplified answers that provide clinicians with the basic information needed at the point of care in treating patients in the Intensive Care Unit. The review has didactic purposes and may serve both as an update on fluid management and as an introduction to the subject for novices in critical care. There is an urgent need to increase awareness regarding the potential risks associated with fluid overload. Clinicians should be mindful not only of the indications for administering fluid loads and of the type of fluids administered, but also of the importance to set safety limits. Lastly, it is important to implement proactive strategies seeking to establish negative fluid balance as soon as the clinical conditions are considered to be stable and the risk of deterioration is low.

Keywords: Colloids; Coloides; Cristaloides; Crystalloids; Echocardiography; Ecocardiografía; Hemodynamic monitoring; Monitoreo hemodinámico; Sepsis; Septic shock; Shock séptico.

Publication types

  • Review

MeSH terms

  • Critical Care*
  • Critical Illness / therapy
  • Fluid Therapy*
  • Humans
  • Intensive Care Units
  • Resuscitation