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The Great(est) Fluid Debate

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Resuscitation fluids save lives in humans with life-threatening hypovolaemia. The fluid of choice should have biochemical characteristics close to the type of fluid lost and replaced at a rate and volume sufficient to correct severe fluid deficit. Then stop and consider the early use of catecholamines. There are few indications to give critically ill patients resuscitation fluids after 24 hours of admission. There is no place for synthetic colloids of non-physiological crystalloids. The effects of unnecessary fluids last well beyond the initial resuscitation period and are associated with adverse effects and harm to the patient. Fluids are toxic drugs and must be used with great care.

Publicado en: Atención sanitaria
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The Great(est) Fluid Debate

  1. 1. The greatest fluid debate @DogICUma @toddrice_ICU @JAMyburgh
  2. 2. The greatest fluid debate @srrezaie @DogICUma @toddrice_ICU @JAMyburgh
  3. 3. The greatest fluid chat @DogICUma @toddrice_ICU @JAMyburgh
  4. 4. 45 year old diabetic male Severe generalised abdominal pain Vomiting Rigors Calls an ambulance
  5. 5. High heart rate – 140bpm High fever – 39°C Low blood pressure – 78/40
  6. 6. Septic shock Abdominal source
  7. 7. Fluids first vs. Fluids + pressors vs. Pressors first
  8. 8. An echo is mandatory vs. An echo is generally helpful vs. An echo is generally unhelpful
  9. 9. Balanced crystalloid vs. 0.9% Saline vs. Colloid
  10. 10. 8L +ve & 8kg heavier On mod. dose noradrenaline Intravascularly deplete
  11. 11. @DogICUma @toddrice_ICU @JAMyburgh all icons: