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Updated: Dec 15, 2025

A Novel Approach for the Administration of Medications and Fluids in Emergency Scenarios and Settings

A Novel Approach for the Administration of Medications and Fluids in Emergency Scenarios and Settings

Published on: November 9, 2016

Fluid administration for acute circulatory dysfunction using basic monitoring.

Antonio Messina^1,2, Francesca Collino¹, Maurizio Cecconi^1,2

¹Humanitas clinical and research center, IRCCS, Rozzano, MI, Italy.

Annals of Translational Medicine

|July 11, 2020

Summary

This summary is machine-generated.

Basic hemodynamic monitoring effectively guides fluid resuscitation in acute circulatory dysfunction. While early fluid administration is crucial, optimal targets for stopping fluid therapy require further definition to prevent organ dysfunction.

Keywords:

Shock acute circulatory failure clinical examination fluid therapy

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Area of Science:

Critical Care Medicine
Hemodynamics
Fluid Management

Background:

Acute circulatory dysfunction requires prompt intervention to prevent multi-organ failure.
Fluid administration is a cornerstone therapy for acute circulatory dysfunction.
Defining precise hemodynamic targets for fluid therapy remains challenging.

Purpose of the Study:

To evaluate the role and effectiveness of basic hemodynamic monitoring.
To guide and titrate fluid administration in patients with acute circulatory dysfunction.
To explore methods for recognizing and managing circulatory shock.

Main Methods:

Review of clinical examination findings for assessing cardiac function and oxygen demand.
Utilization of skin mottling and capillary refill time for guiding shock therapy.
Incorporation of lactate levels, central venous oxygen saturation, and venous-to-arterial CO2 difference for therapy monitoring.
Integration of bedside echocardiography in clinical assessment.

Main Results:

Bedside clinical examination reliably identifies mismatches in cardiac function and oxygen demand.
Semi-quantitative assessment of skin mottling and capillary refill time aids in guiding shock therapy.
Lactate, ScvO2, and CO2 gap effectively track therapeutic responses over time.
Echocardiography is increasingly utilized in daily clinical practice.

Conclusions:

Basic hemodynamic monitoring, including clinical signs and advanced parameters, is vital for managing acute circulatory dysfunction.
Prompt fluid resuscitation is essential in early circulatory failure.
Further research is needed to define optimal hemodynamic endpoints for fluid therapy cessation.