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Fluid Resuscitation

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Surgical Intensive Care Medicine

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Abstract

Intravenous resuscitation fluids are administered to critically ill patients primarily to correct symptomatic hypovolaemia. Crystalloids are pragmatic first-line resuscitation fluids for the majority of patients with little evidence that colloids confer any clinical benefit over crystalloids. Fluids should be selected according to the cause and severity of hypovolaemia that vary over the course of acute illness, to prevent toxicity, specifically physiological or organ dysfunction associated with the type of fluid, particularly semi-synthetic colloids and chloride-rich crystalloids, and to minimise excess cumulative fluid balance that is independently associated with adverse outcomes.

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References

  1. Foex B. How the cholera epidemic of 1831 resulted in a new technique for fluid resuscitation. Emerg Med J. 2003;20:316–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. MacGillivray N. Dr. Thomas Latta: the father of intravenous infusion therapy. J Infect Prev. 2009;10:S3–6.

    Article  Google Scholar 

  3. Lee J. Sydney Ringer (1834–1910) and Alexis Hartmann (1898–1964). Anaesthesia. 1981;36:1115–21.

    Article  CAS  PubMed  Google Scholar 

  4. American National Red Cross. History of blood transfusion 2014 (cited 2014 4th April). Available from: http://www.redcrossblood.org/learn-about-blood/history-blood-transfusion

  5. Haase N, Perner A. Hydroxyethyl starch for resuscitation. Curr Opin Crit Care. 2013;19:321–5.

    Article  PubMed  Google Scholar 

  6. FDA. [cited 2014 17th April]. Available from: www.fda.gov/downloads/biologicsbloodvaccines/newsevents/workshopsmeetingsconferences/ucm325456.ppt

  7. Westphal M, James M, Kozek-Langenecker S, Stocker R, Guidet B, Van Aken H. Hydroxyethyl starches: different products-different effects. Anesthesiology. 2009;111:187–202.

    Article  CAS  PubMed  Google Scholar 

  8. Edelman I, Leibman J. Anatomy of body water and electrolytes. Am J Med. 1959;27:256–77.

    Article  CAS  PubMed  Google Scholar 

  9. Starling E. On the absorption of fluids from the connective tissue spaces. J Physiol. 1896;19:312–26.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Levick J, Michel C. Microvascular fluid exchange and the revised Starling principle. Cardiovasc Res. 2010;87:198–210.

    Article  CAS  PubMed  Google Scholar 

  11. Woodcock TM, Woodcock TE. Revised Starling equation and the glycocalyx model of transvascular fluid exchange: an improved paradigm for prescribing intravenous fluid therapy. Br J Anaesth. 2012;108:384–94.

    Article  CAS  PubMed  Google Scholar 

  12. Myburgh JA, Mythen MG. Resuscitation fluids. N Engl J Med. 2013;369:1243–51.

    Article  CAS  PubMed  Google Scholar 

  13. Cochrane Injuries Group Albumin Reviewers. Human albumin administration in critically ill patients: systematic review of randomised controlled trials. BMJ. 1998;317:235–40.

    Article  Google Scholar 

  14. SAFE Study Investigators. A comparison of albumin and saline for fluid resuscitation in the intensive care unit. N Engl J Med. 2004;350:2247–56.

    Article  Google Scholar 

  15. Cooper DJ, Myburgh J, Heritier S, Finfer S, Bellomo R, Billot L, et al. Albumin resuscitation for traumatic brain injury: is intracranial hypertension the cause of increased mortality? J Neurotrauma. 2013;30:512–8.

    Article  PubMed  PubMed Central  Google Scholar 

  16. SAFE Study Investigators. Saline or albumin for fluid resuscitation in patients with traumatic brain injury. N Engl J Med. 2007;357:874–84.

    Article  Google Scholar 

  17. The SAFE Study Investigators. Impact of albumin compared to saline on organ function and mortality of patients with severe sepsis. Intensive Care Med. 2011;37:86–96.

    Article  Google Scholar 

  18. Caironi P, Tognoni G, Masson S, Fumagalli R, Pesenti A, Romero M, et al. Albumin replacement in patients with severe sepsis or septic shock. N Engl J Med. 2014;10:1412–21.

    Article  Google Scholar 

  19. Myburgh J, McIntyre L. New insights into fluid resuscitation. Intensive Care Med. 2013;39:998–1001.

    Article  CAS  PubMed  Google Scholar 

  20. Maitland K, Kiguli S, Opoka RO, Engoru C, Olupot-Olupot P, Akech SO, et al. Mortality after fluid bolus in African children with severe infection. N Engl J Med. 2011;364:2483–95.

    Article  CAS  PubMed  Google Scholar 

  21. Maitland K, George EC, Evans JA, Kiguli S, Olupot-Olupot P, Akech SO, et al. Exploring mechanisms of excess mortality with early fluid resuscitation: insights from the FEAST trial. BMC Med. 2013;11:68.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Myburgh J, Finfer S. Causes of death after fluid bolus resuscitation: new insights from FEAST. BMC Med. 2013;11:67.

    PubMed  PubMed Central  Google Scholar 

  23. Finfer S, Liu B, Taylor C, Bellomo R, Billot L, Cook D, et al. Resuscitation fluid use in critically ill adults: an international cross-sectional study in 391 intensive care units. Crit Care. 2010;14:R185.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Brunkhorst FM, Engel C, Bloos F, Meier-Hellmann A, Ragaller M, Weiler N, et al. Intensive insulin therapy and pentastarch resuscitation in severe sepsis. N Engl J Med. 2008;358:125–39.

    Article  CAS  PubMed  Google Scholar 

  25. Schortgen F, Lacherade JC, Bruneel F, Cattaneo I, Hemery F, Lemaire F, et al. Effects of hydroxyethylstarch and gelatin on renal function in severe sepsis: a multicentre randomised study. Lancet. 2001;357:911–6.

    Article  CAS  PubMed  Google Scholar 

  26. Myburgh J, Finfer S, Bellomo R, Billot L, Cass A, Gattas D, et al. Hydroxyethyl starch or saline for fluid resuscitation in intensive care. N Engl J Med. 2012;367:1901–11.

    Article  CAS  PubMed  Google Scholar 

  27. Perner A, Haase N, Guttormsen AB, Tenhunen J, Klemenzson G, Åneman A, et al. Hydroxyethyl starch 130/0.42 versus Ringer’s acetate in severe sepsis. N Engl J Med. 2012;367:124–34.

    Article  CAS  PubMed  Google Scholar 

  28. Haase N, Wetterslev J, Winkel P, Perner A. Bleeding and risk of death with hydroxyethyl starch in severe sepsis: post hoc analyses of a randomized clinical trial. Intensive Care Med. 2013;39:2126–34.

    Article  CAS  PubMed  Google Scholar 

  29. Perel P, Roberts I, Ker K. Colloids versus crystalloids for fluid resuscitation in critically ill patients. Cochrane Database Syst Rev. 2013;2, CD000567.

    PubMed  Google Scholar 

  30. FDA. Hydroxyethyl starch solutions: FDA safety communication – boxed warning on increased mortality and severe renal injury and risk of bleeding 2013. Available from: http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm358349.htm

  31. MHRA. Press release: MHRA suspends use of hydroxyethyl starch (HES) drips 2013. Available from: http://www.mhra.gov.uk/NewsCentre/Pressreleases/CON287028

  32. TGA. Monitoring communication: hydroxyethyl starch (Voluven and Volulyte) and increased risk of mortality 2013. Available from: http://www.tga.gov.au/safety/ews-medicine-hydroxyethyl-starch-130709.htm

  33. Bellomo R, Bion J, Finfer S, Myburgh J, Perner A, Reinhart K. Open letter to the executive director of the European medicines agency concerning the licensing of hydroxyethyl starch solutions for fluid resuscitation. Br J Anaesth. 2014;112:595–600.

    Article  CAS  PubMed  Google Scholar 

  34. Bayer O, Reinhart K, Sakr Y, Kabisch B, Kohl M, Riedemann NC, et al. Renal effects of synthetic colloids and crystalloids in patients with severe sepsis: a prospective sequential comparison. Crit Care Med. 2011;39:1335–42.

    Article  CAS  PubMed  Google Scholar 

  35. Schabinski F, Oishi J, Tuche F, Luy A, Sakr Y, Bredle D, et al. Effects of a predominantly hydroxyethyl starch (HES)-based and a predominantly non HES-based fluid therapy on renal function in surgical ICU patients. Intensive Care Med. 2009;35:1539–47.

    Article  CAS  PubMed  Google Scholar 

  36. Yunos NM, Kim IB, Bellomo R, Bailey M, Ho L, Story D, et al. The biochemical effects of restricting chloride-rich fluids in intensive care. Crit Care Med. 2011;39:2419–24.

    Article  CAS  PubMed  Google Scholar 

  37. Morgan T, Venkatesh B, Hall J. Crystalloid strong ion difference determines metabolic acid–base change during acute normovolaemic haemodilution. Intensive Care Med. 2004;30:1432–7.

    Article  PubMed  Google Scholar 

  38. Handy J, Soni N. Physiological effects of hyperchloraemia and acidosis. Br J Anaesth. 2008;101:141–50.

    Article  CAS  PubMed  Google Scholar 

  39. Kellum J, Song M, Li J. Science review: extracellular acidosis and the immune response: clinical and physiologic implications. Crit Care. 2004;8:331–6.

    Article  PubMed  PubMed Central  Google Scholar 

  40. Kellum J, Song M, Almasri E. Hyperchloremic acidosis increases circulating inflammatory molecules in experimental sepsis. Chest. 2006;130:962–7.

    Article  CAS  PubMed  Google Scholar 

  41. Reid F, Lobo D, Williams R, Rowlands B, Allison S. (Ab)normal saline and physiological Hartmann’s solution: a randomized double-blind crossover study. Clin Sci. 2003;104:17–24.

    CAS  PubMed  Google Scholar 

  42. Wilkes N, Woolf R, Mutch M, Mallett S, Peachey T, Stephens R, et al. The effects of balanced versus saline-based hetastarch and crystalloid solutions on acid–base and electrolyte status and gastric mucosal perfusion in elderly surgical patients. Anesth Analg. 2001;93:811–6.

    Article  CAS  PubMed  Google Scholar 

  43. Arlati S, Storti E, Pradella V, Bucci L, Vitolo A, Pulici M. Decreased fluid volume to reduce organ damage: a new approach to burn shock resuscitation? A preliminary study. Resuscitation. 2007;72:371–8.

    Article  CAS  PubMed  Google Scholar 

  44. Advanced Trauma Life Support (ATLS) for doctors Chicago. American College of Surgeons Committee on Trauma 2012. Available from: http://www.facs.org/trauma/atls/index.html

  45. Powell-Tuck J, Gosling P, Lobo D, Allison S, Carlson G, Gore M, et al. British consensus guidelines on intravenous fluid therapy for adult surgical patients (GIFTASUP); 2011. Available from: http://www.bapen.org.uk/pdfs/bapen_pubs/giftasup.pdf

  46. Shaw A, Bagshaw S, Goldstein S, et al. Major complications, mortality, and resource utilization after open abdominal surgery: 0.9 % saline compared to Plasma-Lyte. Ann Surg. 2012;255:821–9.

    Article  PubMed  Google Scholar 

  47. Raghunathan K, Shaw A, Nathanson B, Stürmer T, Brookhart A, Stefan M, et al. Association between the choice of IV crystalloid and in-hospital mortality among critically ill adults with sepsis. Crit Care Med. 2014;42:1585–91.

    Article  CAS  PubMed  Google Scholar 

  48. The National Heart Lung, and Blood Institute Acute Respiratory Distress Syndrome (ARDS) Clinical Trial Network. Comparison of two fluid-management strategies in acute lung injury. N Engl J Med. 2006;354:2564–75.

    Article  Google Scholar 

  49. Gustafsson U, Scott M, Schwenk W, Demartines N, Roulin D, Francis N, et al. Guidelines for perioperative care in elective colonic surgery: enhanced recovery after surgery (ERAS(®)) Society recommendations. World J Surg. 2013;37:259–84.

    Article  CAS  PubMed  Google Scholar 

  50. Cordemans C, De Laet I, Van Regenmortel N, Schoonheydt K, Dits H, Huber W, et al. Fluid management in critically ill patients: the role of extravascular lung water, abdominal hypertension, capillary leak, and fluid balance. Ann Intensive Care. 2012;2 Suppl 1:S1.

    Article  PubMed  PubMed Central  Google Scholar 

  51. Boyd JH, Forbes J, Nakada TA, Walley KR, Russell JA. Fluid resuscitation in septic shock: a positive fluid balance and elevated central venous pressure are associated with increased mortality. Crit Care Med. 2011;39:259–65.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Malcolm Fisher Department of Intensive Care, Royal North Shore Hospital, Level 6, Acute Services Building, Pacific Highway, St. Leonard’s, NSW, Australia

    Naomi E. Hammond BN, MN (Crit. Care), MPH

  2. Department of Intensive Care Medicine, St. George Hospital, Gray Street, Kogarah, NSW, Australia

    Manoj K. Saxena MBBChir, BSc & John A. Myburgh AO, MBBCh, PhD, FCICM

Authors
  1. Naomi E. Hammond BN, MN (Crit. Care), MPH
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  2. Manoj K. Saxena MBBChir, BSc
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  3. John A. Myburgh AO, MBBCh, PhD, FCICM
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Corresponding author

Correspondence to Naomi E. Hammond BN, MN (Crit. Care), MPH .

Editor information

Editors and Affiliations

  1. Department of Surgical Critical Care; Lahey Hospital and Medical Center, Division of Surgery, Burlington, Massachusetts, USA

    John M. O'Donnell

  2. Surgical Critical Care Medicine, Pr�-Card�o Hospital, Critical Care Medicine, University Hospital, Federal University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil

    Flávio E. Nácul

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© 2016 Springer International Publishing Switzerland

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Hammond, N.E., Saxena, M.K., Myburgh, J.A. (2016). Fluid Resuscitation. In: O'Donnell, J., Nácul, F. (eds) Surgical Intensive Care Medicine. Springer, Cham. https://doi.org/10.1007/978-3-319-19668-8_4

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  • DOI: https://doi.org/10.1007/978-3-319-19668-8_4

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-19667-1

  • Online ISBN: 978-3-319-19668-8

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