The administration of intravenous fluids is perhaps the most common treatment given in the intensive care unit. According to biologic rationale, ongoing fluid losses should be replaced to maintain fluid homeostasis and relative or absolute deficiencies in circulating blood volume should be prevented or rapidly corrected. There is agreement that insensible fluid losses and isotonic fluid losses should be replaced with a judicious mixture of water and crystalloid solutions. There is, however, a great deal of controversy on which fluids should be used during the acute resuscitation phase to deal with acute relative or absolute hypovolemia. In particular, there is much controversy on whether colloidal or crystalloid solutions should be used. The controversy remains despite multiple meta-analyses. There are suggestions that albumin might increase mortality but the data supporting these concerns are weak. Starch solutions might adversely affect renal function. Crystalloids might be favored in trauma patients. These views remain inadequately supported by evidence. A randomized controlled trial now under way should increase the evidence base for practice in this area.

This content is only available via PDF.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.