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Optimizing fluid therapy in shock.
Curr Opin Crit Care. 2019 Jun;25(3):246-251
Authors: Marik PE, Weinmann M
Abstract
PURPOSE OF REVIEW: Shock, best defined as acute circulatory failure is classified into four major groups, namely hypovolemic, cardiogenic, obstructive, and distributive (vasodilatory). The purpose of this review is to provide a practical approach to fluid optimization in patients with the four types of shock.
RECENT FINDINGS: Large-volume fluid resuscitation has traditionally been regarded as the cornerstone of resuscitation of shocked patients. However, in many instances, aggressive fluid resuscitation may be harmful, increasing morbidity and mortality.
SUMMARY: We believe that the approach to fluid therapy must be individualized based on the cause of shock as well as the patient's major diagnosis, comorbidities and hemodynamic and respiratory status. A conservative, physiologically guided approach to fluid resuscitation likely improves patient outcomes.
PMID: 31022087 [PubMed - in process]