Principles of Fluid Management in Critical Care

Abstract

Critically ill patients are those who are at risk of developing acute cardiovascular insufficiency or shock from any cause. The most common cause of shock has some degree of insufficient intravascular volume and fluid- electrolyte imbalance. Fluid therapy is a dynamic intervention and Volume expansion with fluid is recognized as first step of resuscitation. IV fluid therapy is routinely prescribed across a broad range of clinical settings, including the management of critically ill patients with infection. Fluid–electrolyte therapy is simplified if approached systematically. Determine the primary etiology responsible for fluid and electrolyte disorders and Priority must be established in the treatment of fluid and electrolyte disorders. Therapy must be first directed toward the correction of abnormality that constitutes the greatest threat to patient’s life. The broad topic of fluids involves intravenous fluid volume, fluid composition, timing of fluid administration, source of fluid intake and output methods. To avoid volume overload and its associated complications, strategies should be identified and developed for fluid responsiveness among ICU patients. Apart from fluid resuscitation the type of fluid used also impact patient outcome. It is important to concentrate on certain aspects in fluid management and can be broadly discussed on: (1)Resuscitation fluids. (2) Maintenance fluids. (3) Replacement solutions. (4)Nutritional and other fluids.