Applied Physiology of Fluid Resuscitation in Critical Illness

Critical Care Clinics
Sabrina Arshed, Michael R Pinsky

Abstract

Fluids during resuscitation from shock increase mean systemic pressure and venous return. The pressure gradient for venous return must increase. Mean systemic pressure is the amount of vascular space in unstressed and stressed volume, mostly unstressed. Shock states can decrease mean systemic pressure by increasing unstressed volume, decreasing total blood volume, or decreasing the pressure gradient for venous return. Crystalloids across bodily spaces restore normal volume, whereas colloids remain in the intravascular space. Electrolyte content of fluids matters and excess chloride impairs renal blood flow. Albumin seems to be more effective at restoring blood volume in severe sepsis, but not in other conditions.

Citations

Dec 7, 2018·Current Opinion in Anaesthesiology·Alessia Pedoto, Albert C Perrino
Nov 28, 2018·Journal of Clinical Monitoring and Computing·Rita JacobsManu L N G Malbrain
Sep 13, 2018·Critical Care : the Official Journal of the Critical Care Forum·Jean-Louis Vincent, Michael R Pinsky

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