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Should Albumin be the Colloid of Choice for Fluid Resuscitation in Hypovolemic Patients?

  • J. Montomoli
  • A. Donati
  • C. InceEmail author
Chapter
Part of the Annual Update in Intensive Care and Emergency Medicine book series (AUICEM)

Abstract

Hemodynamic management represents a major therapeutic challenge in critical care and emergency medicine. It plays a key role during the entire healing process of a patient from hospital admission to discharge. Within hemodynamic stabilization, resuscitation is one of the major indications for fluid administration and is often a life-saving therapy that has to be administered as soon as possible, with the right dose and rate, and choosing the right types of fluid. Unfortunately, these pillars of fluid therapy are not supported by consistent and solid evidence in the scientific literature. The agreement on the right fluid for the right patient is a mantra that is still a source of debate. However, after the restriction of hydroxyethyl starch (HES) use in critically ill patients issued by the European Medicine Agency (EMA) and the Food and drug Administration (FDA) in 2013, crystalloids now dominate resuscitation fluids in hypovolemia although recent evidence has demonstrated increased mortality in critically ill patients receiving 0.9% NaCl (normal saline)—by far, one of the most used crystalloids [1].

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Anesthesia and Intensive Care, Department of Biomedical Sciences and Public HealthUniversità Politecnica delle MarcheAnconaItaly
  2. 2.Department of Intensive Care, Erasmus MCUniversity Medical Center RotterdamRotterdamThe Netherlands

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