Fluid administration in critically ill patients

Abstract

Introduction: the administration of fluids constitutes one of the fundamental pillars in the treatment of seriously ill patients; only 50 % respond to this procedure and there is an inconsistency between macro and microhemodynamic variables, which makes monitoring more complex. Current research focuses on multiple monitoring variables and various strategies for fluid administration in the critically ill patient.

Objective: to update the evidence on the administration of fluids in the seriously ill patient.

Methods: the studies published in the PubMed, SciELO Cuba, Cumed databases and in the Google Academic search engine were reviewed. The papers published in the last five years, in English and Spanish languages, were selected.

Development: evidences related to the variables of monitoring for the administration of fluids, and strategies for its maintenance are presented. In this regard, the authors present their critical considerations.

Conclusions: there is a consensus that the initial administration of fluids in patients in shock should be early and aggressive to restore blood volume. Fluid administration needs monitoring variables to effectively define the patient who benefits from its use, taking into account that the signs of the physical examination, the most common physiological variables, and the radiographic study are not very effective in guiding their contribution. Despite the evidence that fluid overload worsens the patient's prognosis, there is still no consensus regarding volume maintenance in critically ill patients. Therefore, new studies are required to address this issue