Guiding principles of fluid and volume therapy

Aditianingsih, Dita; George, Y

doi:10.1016/j.bpa.2014.07.002

Cited by 31 publications

(45 citation statements)

References 71 publications

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“…The fluid that passes an intact vascular barrier through the intravascular and extravascular spaces is reabsorbed by the lymphatic system, making it impossible to develop edema. (6) However, when inflammatory processes cause damage, the endothelial glycocalyx barrier breaks down, causing fluid extravasation and, as the process progresses, edema (Figure 1). (7) …”

Section: Pathophysiologymentioning

confidence: 99%

“…The relative decrease in circulating volume leads to hypotension, tissue hypoperfusion, and organ dysfunction. (6,8,9) …”

Section: Pathophysiologymentioning

confidence: 99%

“…(1,6,27) These solutions are composed of ions with variable tonicity that can be distributed freely through the endothelial barrier. Saline solution is isotonic relative to plasma but has higher chloride concentrations, thus predisposing patients to hyperchloremic metabolic acidosis.…”

Section: Composition Of Resuscitation Fluidsmentioning

confidence: 99%

“…(26,28) The infused liquid becomes distributed in approximately 30 minutes, and after this period, the increase in plasma volume is 50 to 75%. (6) …”

Section: Composition Of Resuscitation Fluidsmentioning

confidence: 99%

“…These fluids are classified as natural (albumin) or artificial (gelatins, dextrans, and hydroxyethyl starch [HES]). (6,26) …”

Section: Composition Of Resuscitation Fluidsmentioning

confidence: 99%

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Fluid overload in children undergoing mechanical ventilation

Lopes¹,

Piva²

2017

Revista Brasileira De Terapia Intensiva

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Patients admitted to an intensive care unit are prone to cumulated fluid overload and receive intravenous volumes through the aggressive resuscitation recommended for septic shock treatment, as well as other fluid sources related to medications and nutritional support. The liberal liquid supply strategy has been associated with higher morbidity and mortality. Although there are few prospective pediatric studies, new strategies are being proposed. This non-systematic review discusses the pathophysiology of fluid overload, its consequences, and the available therapeutic strategies. During systemic inflammatory response syndrome, the endothelial glycocalyx is damaged, favoring fluid extravasation and resulting in interstitial edema. Extravasation to the third space results in longer mechanical ventilation, a greater need for renal replacement therapy, and longer intensive care unit and hospital stays, among other changes. Proper hemodynamic monitoring, as well as cautious infusion of fluids, can minimize these damages. Once cumulative fluid overload is established, treatment with long-term use of loop diuretics may lead to resistance to these medications. Strategies that can reduce intensive care unit morbidity and mortality include the early use of vasopressors (norepinephrine) to improve cardiac output and renal perfusion, the use of a combination of diuretics and aminophylline to induce diuresis, and the use of sedation and early mobilization protocols.

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Section: Pathophysiologymentioning

confidence: 99%

“…The relative decrease in circulating volume leads to hypotension, tissue hypoperfusion, and organ dysfunction. (6,8,9) …”

Section: Pathophysiologymentioning

confidence: 99%

Section: Composition Of Resuscitation Fluidsmentioning

confidence: 99%

“…(26,28) The infused liquid becomes distributed in approximately 30 minutes, and after this period, the increase in plasma volume is 50 to 75%. (6) …”

Section: Composition Of Resuscitation Fluidsmentioning

confidence: 99%

“…These fluids are classified as natural (albumin) or artificial (gelatins, dextrans, and hydroxyethyl starch [HES]). (6,26) …”

Section: Composition Of Resuscitation Fluidsmentioning

confidence: 99%

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