Choice of fluids in critically ill patients

Area of Science:

• Critical care medicine
• Pharmacology
• Nephrology

Background:

• Intravenous fluids are the most common treatment in patient care.
• During critical illness, fluids are administered to maintain cardiac output and tissue oxygenation.

Purpose of the Study:

• To review current evidence on fluid solutions and their management in critically ill patients.
• To highlight the understanding of intravenous fluids as medications with physiological effects.

Main Methods:

• Review of existing evidence on fluid management in specific clinical settings.
• Discussion of the risk/benefit ratio of fluid administration and composition.

Main Results:

• Intravenous fluids affect cardiovascular, renal, gastrointestinal, and immune systems.
• Fluid administration requires careful consideration of volume, composition, and patient physiology.
• Assessment of fluid responsiveness and periodic reconsideration of fluid types are crucial.

Conclusions:

• Intravenous fluids should be viewed as medications due to their physiological effects.
• Evidence-based fluid management is critical in specific clinical settings like sepsis, ARDS, surgery, AKI, and trauma.