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15 - Fluid therapy

Published online by Cambridge University Press:  05 September 2009

Peter Choi
Affiliation:
Department of Anesthesia, Vancouver Hospital, University of British Columbia, Vancouver, British Columbia, Canada
J Mark Ansermino
Affiliation:
Department of Pediatric Anesthesia, British Columbia Children's Hospital, Vancouver, British Columbia, Canada
Ann Møller
Affiliation:
KAS Herlev, Copenhagen
Tom Pedersen
Affiliation:
Rigshospitalet, Copenhagen
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Summary

Despite hundreds of laboratory and clinical studies, the choice of intravenous (IV) fluid, the volume of fluid to be administered, and the timing of fluid administration remain controversial. Based on the evidence from clinical trials and meta-analyses, a statistically significant reduction in mortality or relevant adverse clinical outcomes amongst surgical or critically ill adult or paediatric patients has not been found with the use of any particular IV fluid.

Restrictive fluid regimens may decrease perioperative morbidity in adults undergoing elective intra-abdominal surgery but the results cannot be generalised to other populations or procedures. The effect of restricted versus liberal fluid regimens on clinical outcomes in patients undergoing minimally invasive or ambulatory procedures is still inconclusive.

Although there is a trend in fewer deaths with delayed fluid resuscitation of patients with penetrating trauma, the data are insufficient to draw guidelines. Large multicentre randomised controlled trials (RCTs) of fluid regimens with clinically relevant outcomes are still needed to address important questions in this field.

Introduction

The use of IV fluids for volume resuscitation and fluid replacement in the surgical or critically ill patient has been studied and practiced for nearly 90 years. Despite hundreds of laboratory and clinical studies, the choice of IV fluid, the volume of fluid to be administered, and the timing of fluid administration remain controversial.

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Publisher: Cambridge University Press
Print publication year: 2006

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  • Fluid therapy
    • By Peter Choi, Department of Anesthesia, Vancouver Hospital, University of British Columbia, Vancouver, British Columbia, Canada, J Mark Ansermino, Department of Pediatric Anesthesia, British Columbia Children's Hospital, Vancouver, British Columbia, Canada
  • Edited by Ann Møller, KAS Herlev, Copenhagen, Tom Pedersen, Rigshospitalet, Copenhagen
  • Book: Evidence-based Anaesthesia and Intensive Care
  • Online publication: 05 September 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544613.016
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  • Fluid therapy
    • By Peter Choi, Department of Anesthesia, Vancouver Hospital, University of British Columbia, Vancouver, British Columbia, Canada, J Mark Ansermino, Department of Pediatric Anesthesia, British Columbia Children's Hospital, Vancouver, British Columbia, Canada
  • Edited by Ann Møller, KAS Herlev, Copenhagen, Tom Pedersen, Rigshospitalet, Copenhagen
  • Book: Evidence-based Anaesthesia and Intensive Care
  • Online publication: 05 September 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544613.016
Available formats
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Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • Fluid therapy
    • By Peter Choi, Department of Anesthesia, Vancouver Hospital, University of British Columbia, Vancouver, British Columbia, Canada, J Mark Ansermino, Department of Pediatric Anesthesia, British Columbia Children's Hospital, Vancouver, British Columbia, Canada
  • Edited by Ann Møller, KAS Herlev, Copenhagen, Tom Pedersen, Rigshospitalet, Copenhagen
  • Book: Evidence-based Anaesthesia and Intensive Care
  • Online publication: 05 September 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544613.016
Available formats
×