Cargando…
Issues in contemporary fluid management
Fluid management strategies need to be guided by an understanding of the pathophysiologic mechanisms underlying fluid imbalance. In the hypovolaemic patient, reduced circulating blood volume and venous return and, in severe cases, altered tissue perfusion may initiate a cascade of pathophysiologic p...
Autor principal: | |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2000
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3226169/ https://www.ncbi.nlm.nih.gov/pubmed/11255591 http://dx.doi.org/10.1186/cc964 |
_version_ | 1782217574175473664 |
---|---|
author | Vincent, Jean-Louis |
author_facet | Vincent, Jean-Louis |
author_sort | Vincent, Jean-Louis |
collection | PubMed |
description | Fluid management strategies need to be guided by an understanding of the pathophysiologic mechanisms underlying fluid imbalance. In the hypovolaemic patient, reduced circulating blood volume and venous return and, in severe cases, altered tissue perfusion may initiate a cascade of pathophysiologic processes culminating in multiple organ failure. The objectives of fluid management are to maintain adequate blood pressure, tissue oxygenation and intravascular fluid volume. Both crystalloids and colloids can be useful for these purposes. In the hypovolaemic patient with normal pulmonary function, the use of colloids to maintain colloid osmotic pressure can limit the development of peripheral as well as pulmonary oedema. However, choice of fluid is less important in states of increased lung capillary permeability. Further evidence is needed to broaden understanding of the optimal roles for particular fluid management strategies. Experimental models can make an important contribution in gathering such evidence. Rigorous pharmacoeconomic studies are also needed to define the benefits and costs of differing fluid regimens. |
format | Online Article Text |
id | pubmed-3226169 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2000 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-32261692011-11-30 Issues in contemporary fluid management Vincent, Jean-Louis Crit Care Proceedings Fluid management strategies need to be guided by an understanding of the pathophysiologic mechanisms underlying fluid imbalance. In the hypovolaemic patient, reduced circulating blood volume and venous return and, in severe cases, altered tissue perfusion may initiate a cascade of pathophysiologic processes culminating in multiple organ failure. The objectives of fluid management are to maintain adequate blood pressure, tissue oxygenation and intravascular fluid volume. Both crystalloids and colloids can be useful for these purposes. In the hypovolaemic patient with normal pulmonary function, the use of colloids to maintain colloid osmotic pressure can limit the development of peripheral as well as pulmonary oedema. However, choice of fluid is less important in states of increased lung capillary permeability. Further evidence is needed to broaden understanding of the optimal roles for particular fluid management strategies. Experimental models can make an important contribution in gathering such evidence. Rigorous pharmacoeconomic studies are also needed to define the benefits and costs of differing fluid regimens. BioMed Central 2000 2000-10-13 /pmc/articles/PMC3226169/ /pubmed/11255591 http://dx.doi.org/10.1186/cc964 Text en Copyright ©2000 Current Science Ltd |
spellingShingle | Proceedings Vincent, Jean-Louis Issues in contemporary fluid management |
title | Issues in contemporary fluid management |
title_full | Issues in contemporary fluid management |
title_fullStr | Issues in contemporary fluid management |
title_full_unstemmed | Issues in contemporary fluid management |
title_short | Issues in contemporary fluid management |
title_sort | issues in contemporary fluid management |
topic | Proceedings |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3226169/ https://www.ncbi.nlm.nih.gov/pubmed/11255591 http://dx.doi.org/10.1186/cc964 |
work_keys_str_mv | AT vincentjeanlouis issuesincontemporaryfluidmanagement |