Author/Editor		Benes, Jan; Kirov, Mikhail; Kuzkov, Vsevolod; Lainščak, Mitja; Molnar, Zsolt; Voga, Gorazd; Monnet, Xavier
Title		Fluid therapy: double-edged sword during critical care?
Type		članek
Vol. and No.		Letnik 2015, št. čl. 729075
Publication year		2015
Volume		str. [str. 1-14]
ISSN		2314-6141 - BioMed research international
Language		eng
Abstract		Fluid therapy is still the mainstay of acute care in patients with shock or cardiovascular compromise. However, our understanding of the critically ill pathophysiology has evolved significantly in recent years. The revelation of the glycocalyx layer and subsequent research has redefined the basics of fluids behavior in the circulation. Using less invasive hemodynamic monitoring tools enables us to assess the cardiovascular function in a dynamic perspective. This allows pinpointing even distinct changes induced by treatment, by postural changes, or by interorgan interactions in real time and enables individualized patient management. Regarding fluids as drugs of any other kind led to the need for precise indication, way of administration, and also assessment of side effects. We possess now the evidence that patient centered outcomes may be altered when incorrect time, dose, or type of fluids are administered. In this review, three major features of fluid therapy are discussed: the prediction of fluid responsiveness, potential harms induced by overzealous fluid administration, and finally the problem of protocol-led treatments and their timing.
Descriptors		Fluid therapy Critical care Zdravljenje s tekočinami Intenzivno zdravljenje