Guiding principles of fluid and volume therapy

Dita Aditianingsih, Yohanes W.H. George

Research output: Contribution to journalReview articlepeer-review

16 Citations (Scopus)

Abstract

Fluid therapy is a core concept in the management of perioperative and critically ill patients for maintenance of intravascular volume and organ perfusion. Recent evidence regarding the vascular barrier and its role in terms of vascular leakage has led to a new concept for fluid administration. The choice of fluid used should be based on the fluid composition and the underlying pathophysiology of the patient. Avoidance of both hypo- and hypervolaemia is essential when treating circulatory failure. In daily practice, the assessment of individual thresholds in order to optimize cardiac preload and avoid hypovolaemia or deleterious fluid overload remains a challenge. Liberal versus restrictive fluid management has been challenged by recent evidence, and the ideal approach appears to be goal-directed fluid therapy.

Original languageEnglish
Pages (from-to)249-260
Number of pages12
JournalBest Practice and Research: Clinical Anaesthesiology
Volume28
Issue number3
DOIs
Publication statusPublished - 2014

Keywords

  • Colloids
  • Crystalloids
  • Double-barrier concept
  • Goal-directed fluid therapy
  • Liberal versus restrictive fluid management
  • Preload responsiveness

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