Fluid and electrolyte overload in critically ill patients: An overview

Area of Science:

• Critical Care Medicine
• Nephrology
• Intensive Care

Background:

• Intravenous fluids are essential for shock and hypovolemia, but evidence highlights potential harm.
• Excessive fluid volumes and non-physiological electrolyte compositions can impair organ function.
• Patients with systemic inflammatory response syndrome often have impaired fluid and electrolyte excretion.

Purpose of the Study:

• To synthesize evidence on the deleterious effects of fluid and electrolyte overload.
• To describe the phenomenon of fluid and electrolyte overload.
• To propose strategies for safe fluid management and weaning in intensive care settings.

Main Methods:

• Literature review and synthesis of existing evidence.
• Analysis of studies examining fluid administration and its impact on organ function.
• Identification of clinical scenarios associated with fluid overload.

Main Results:

• Fluid and electrolyte overload can lead to hypernatremia, hyperchloremic acidosis, and fluid accumulation.
• These complications are linked to worse outcomes, including acute kidney injury, respiratory dysfunction, and increased mortality.
• Excessive fluid administration is associated with longer hospital and intensive care unit stays.

Conclusions:

• Fluid and electrolyte overload is a significant concern in critically ill patients.
• Careful fluid management, including timely weaning, is crucial to improve patient outcomes.
• Clinicians must consider potential fluid-related complications in the intensive care unit.