| Autor: |
Antonio Messina, Jan Bakker, Michelle Chew, Daniel De Backer, Olfa Hamzaoui, Glenn Hernandez, Sheila Nainan Myatra, Xavier Monnet, Marlies Ostermann, Michael Pinsky, Jean-Louis Teboul, Maurizio Cecconi |
| Jazyk: |
angličtina |
| Rok vydání: |
2022 |
| Předmět: |
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| Zdroj: |
Intensive Care Medicine Experimental, Vol 10, Iss 1, Pp 1-15 (2022) |
| Druh dokumentu: |
article |
| ISSN: |
2197-425X |
| DOI: |
10.1186/s40635-022-00473-4 |
| Popis: |
Take-home messages Fluids are drugs used in patients with shock to increase the cardiac output with the aim to improve oxygen delivery to the cells. The response to fluid administration is determined by the physiological interaction of cardiac function and venous return. In septic shock, the beneficial clinical response of fluid administration is rapidly reduced after few hours and fluid titration is crucial to avoid detrimental fluid overload. The fluid challenge is a fluid bolus given at a defined quantity and rate to assess fluid responsiveness. The ideal fluid for critically ill patients does not exist; however, crystalloids should be used as first choice. Balanced crystalloid solutions may be associated with better outcomes but the evidence is still low. Albumin infusion may have a role in already fluid resuscitated patients at risk of fluid overload. Fluid administration is integrated into the complex management of pressure and flow “macro” hemodynamic variables, coupled to the “micro” local tissue flow distribution and regional metabolism. Macro-variables are managed by measuring systemic blood pressure and evaluating the global cardiac function. The critical threshold of oxygen delivery to the cells is difficult to estimate, however, several indexes and clinical signs may be considered as surrogate of that, and integrated in a decision-making process at the bedside. |
| Databáze: |
Directory of Open Access Journals |
| Externí odkaz: |
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