Choice of Fluids in Critically Ill Patients

Claude Martin; Andrea Cortegiani; Cesare Gregoretti; Ignacio Martin-Loeches; Carole Ichai; Marc Leone; Gernot Marx; Sharon Einav

Disclosures

BMC Anesthesiol. 2018;18(200) 

In This Article

Conclusions

Intravenous fluids are drugs and should be prescribed as such. Among the available fluids, crystalloids have the highest benefit/risk ratio and, should generally be prescribed first. For critically ill patients or when large amount of fluids is expected to be infused, balanced solutions should be preferred because of their favourable effects on patient outcomes, including kidney function. The preferred solution for non critically ill patients or low volume resuscitation is less clear. However, given the availability of balanced solutions and their low cost, they could be considered for all patients. The role of albumin remains a matter of debate, but there is indirect evidence that albumin may favourably affect the outcomes of patients with septic shock. The indications and effects of gelatins remain unclear for critically ill patients. The role of dextrans in this patient population should probably remain marginal until more data is forthcoming.

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