From the Physiology to the Bedside: Fluid Therapy in Cardiac Surgery and the ICU
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Purpose of Review
In this review, we summarize the evidence present in the literature about this important field, with particular attention to the peculiarities of cardiac surgery.
Since water is the main component of human cells and tissue, together with electrolytes and proteins, the manipulation of this element in critical illness is a powerful tool in the hands of the anesthesiologist and intensive care doctor. It can be either extraordinarily effective in the treatment of the patient’s disease and in correcting the hemodynamic instability or it can lead to very dangerous consequences, such as edema or end-organ damage. The potential consequences of this therapy require a proper monitoring system and the possibility to correctly assess the probability of the patient to respond to a fluid bolus in the macro- and microhemodynamics.
Fluid therapy has potentially enormous advantages when the indication is correctly given and balanced to the potential side effects.
KeywordsFluid therapy Fluid shift Cardiac surgery Fluid responder Coagulation Kidney injury
Compliance with Ethical Standards
Conflict of Interest
Marcello Guarnieri declares that he has no conflict of interest.
Andrea De Gasperi has received speaker’s honoraria and reimbursement for travel expenses from Fresenius Kabi and Edwards Lifesciences.
Stefano Gianni declares that he has no conflict of interest.
Marco Baciarello has received reimbursement for travel expenses from Theras Lifetech S.R.L. and Abbott Laboratories.
Valentina Bellini declares that she has no conflict of interest.
Elena Bignami declares that she has no conflict of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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