Related Experiment Video
Updated: May 21, 2026

A Novel Approach for the Administration of Medications and Fluids in Emergency Scenarios and Settings
Published on: November 9, 2016
Importance of intravenous fluid dose and composition in surgical ICU patients
Karthik Raghunathan1, William T McGee, Thomas Higgins
1Department of Anesthesiology, Baystate Medical Center, Tufts University School of Medicine, Springfield, Massachusetts, USA. Karthik.Raghunathan@bhs.org
Purpose Of Review:
This review discusses the importance of intravenous fluid dose and composition in surgical ICU patients. On the basis of updated physiologic postulates, we suggest guidelines for the use of crystalloids and colloids. Goal-directed fluid therapy is advocated as a means for avoiding both hypovolemia and hypervolemia.
Recent Findings:
Integrity of the endothelial surface layer (ESL) and 'volume context' are key determinants of fluid disposition. During critical illness the ESL is compromised. Optimal resuscitation may be guided by functional measures of fluid responsiveness with some caveats. The best approach may be to use physiologically balanced crystalloids for hypovolemic resuscitation and colloids for euvolemic hemodynamic augmentation.
Summary:
The routine replacement of unmeasured presumed fluid deficits is not appropriate. In critically ill patients, resuscitation with intravenous fluids should produce a demonstrable enhancement of perfusion. Individualized goal-directed therapy using functional hemodynamic parameters can optimize resuscitation and 'deresuscitation'.
Related Concept Videos
One-Compartment Model: IV Infusion
The one-compartment model for IV infusion uses mathematical equations to describe the rate of change in drug quantity in the body. At steady-state or infusion equilibrium, the drug input...
Composition of Body Fluids
Acute Kidney Injury VI: Nursing Management
Cardiomyopathy VII: Pre and Post Operative Nursing Management
Acute Kidney Injury V: Interprofessional Care
Drug Accumulation During Multiple Dosing: Intermittent IV Infusions

