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Volume Therapy: New Aspects of an Old Topic?

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Book cover Yearbook of Intensive Care and Emergency Medicine 1997

Part of the book series: Yearbook of Intensive Care and Emergency Medicine ((YEARBOOK,volume 1997))

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Abstract

Various conditions such as shock, ischemia, trauma and sepsis trigger flow alterations which are inadequate to fulfill the nutritive role of the circulation [1]. During (hypovolemic-related) low output syndrome (LOS), the organism tries to compensate perfusion deficits by redistribution of flow to vital organs (e.g. heart and brain) resulting in an underperfusion of splanchnic bed, kidneys, muscles, and skin. Various inflammatory mediators and circulating vasoactive substances are of particular importance for deteriorated perfusion in this situation. Activation of the sympathetic nervous system is one of the compensatory mechanisms to maintain peripheral perfusion. Although this compensatory neurohumoral activation is beneficial at first, this mechanism becomes deleterious and may be involved in the bad outcome of the critically ill [2]. Recent evidence suggests that the endothelium does not only function as a passive barrier between the circulating blood and the tissue, but endothelial cells may also be markedly involved in the regulation of microcirculatory blood flow by producing important regulators of the vascular tone (e.g. prostaglandins, nitric oxide (NO), endothelins, angiotensin II) [3–5]. Thus the regional regulation of blood flow is likely due to a balance between systemic (central) mechanisms (e.g. the autononous nervous system) and other circulating or locally active blood flow regulators. In this situation, fluid therapy is aimed to beneficially influence regulators of circulation and to restore abnormal tissue perfusion.

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Authors
  1. J. Boldt
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  2. D. Mentges
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  3. M. Papsdorf
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Editor information

Editors and Affiliations

  1. Department of Intensive Care, Erasme Hospital, Free University of Brussels, Route de Lennik 808, B-1070, Brussels, Belgium

    Jean-Louis Vincent (Clinical Director) (Clinical Director)

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© 1997 Springer-Verlag Berlin Heidelberg

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Boldt, J., Mentges, D., Papsdorf, M. (1997). Volume Therapy: New Aspects of an Old Topic?. In: Vincent, JL. (eds) Yearbook of Intensive Care and Emergency Medicine 1997. Yearbook of Intensive Care and Emergency Medicine, vol 1997. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-13450-4_34

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  • DOI: https://doi.org/10.1007/978-3-662-13450-4_34

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-13452-8

  • Online ISBN: 978-3-662-13450-4

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