Fluid resuscitation
Abstract
Intravenous fluid resuscitation is an important component of anaesthesia and critical care practice. The end point is to increase intravascular volume to augment cardiac output and organ perfusion. Failure to resuscitate patients adequately may lead to multi-organ dysfunction syndrome and, eventually, death. History, clinical signs and haemodynamic indices can all aid in the diagnosis of hypovolaemia although only the latter is reliable. Fluid challenge is a very practical and reliable way to diagnose and correct hypovolaemia. Fluid resuscitation may be attempted with either colloid or crystalloid solution. The benefits of each type of fluid have been widely debated for many years and controversy continues as to whether crystalloid or colloids are preferred for intravascular volume replacement. However, both fluids are capable of correcting hypovolaemia. All patients require a predictable volume (usually 1500–2000 ml day −1 ) of maintenance fluid, which is usually given as a combination of nutritional fluid and crystalloid. Colloid fluids are reserved for supplementation of the intravascular volume.