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Updated: Jun 21, 2026
16:31
Fixed Volume or Fixed Pressure: A Murine Model of Hemorrhagic Shock
Published on: June 6, 2011
Isotonic and hypertonic crystalloid solutions in the critically ill
Michael Bauer1, Andreas Kortgen, Christiane Hartog
1Department of Anesthesiology and Intensive Care Therapy, Friedrich-Schiller-University, Erlanger Allee, 101, D-07747 Jena, Germany. michael.bauer@med.uni-jena.de
Best Practice & Research. Clinical Anaesthesiology
|August 6, 2009
Summary
Fluid and electrolyte balance in critically ill patients requires careful management. Targeting normal values may not be optimal; hyperosmolar states might benefit tissue edema, but more research is needed.
Area of Science:
- Critical care medicine
- Nephrology
- Intensive care
Background:
- Fluid and electrolyte disorders are common in critically ill patients.
- Optimal management strategies for these disorders are debated.
- Specific conditions like intracranial trauma or hepatic encephalopathy may benefit from altered fluid balance goals.
Purpose of the Study:
- To review the current understanding of fluid and electrolyte balance in critically ill patients.
- To discuss the potential role of hyperosmolar states in managing tissue edema.
- To evaluate the evidence for different resuscitation strategies.
Main Methods:
- Literature review of studies on fluid and electrolyte balance in critical illness.
- Analysis of evidence comparing crystalloids, colloids, and vasopressors.
- Discussion of the impact of hypertonic saline on patient outcomes.
Main Results:
- Normal fluid and electrolyte parameters may not be ideal in all critical conditions.
- Hyperosmolar states might reduce brain and intestinal edema.
- Crystalloid resuscitation is effective in blunt trauma shock and comparable to colloids in septic shock.
- Traditional fluid resuscitation guidelines may be inaccurate.
Conclusions:
- Fluid and electrolyte management in critical illness is complex and condition-dependent.
- Hypertonic saline's role in improving outcomes requires further investigation.
- Current resuscitation practices should be evidence-based, moving beyond outdated rules of thumb.
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