• Ashley Barlow, Brooke Barlow, Nancy Tang, Bhavik M Shah, and Amber E King.
• Ashley Barlow is an oncology pharmacy resident, Department of Pharmacy Services, The University of Texas MD Anderson Cancer Center, Houston, Texas.
• Crit Care Nurse. 2020 Dec 1; 40 (6): e17-e27.

TopicThis article reviews the management of intravenous fluids and the evaluation of volume status in critically ill adults.Clinical RelevanceIntravenous fluid administration is one of the most common interventions in the intensive care unit. Critically ill patients have dynamic fluid requirements, making the management of fluid therapy challenging. New literature suggests that balanced salt solutions may be preferred in some patient populations.Purpose Of PaperThe bedside critical care nurse must understand the properties of various intravenous fluids and their corresponding impact on human physiology. The nurse's clinical and laboratory assessments of each patient help define the goals of fluid therapy, which will in turn be used to determine the optimal patient-specific selection and dose of fluid for administration. Nurses serve a vital role in monitoring the safety and efficacy of intravenous fluid therapy. Although this intervention can be lifesaving, inappropriate use of fluids has the potential to yield detrimental effects.Content CoveredThis article discusses fluid physiology and the goals of intravenous fluid therapy, compares the types of intravenous fluids (isotonic crystalloids, including 0.9% sodium chloride and balanced salt solutions; hypotonic and hypertonic crystalloids; and colloids) and their adverse effects and impact on hemodynamics, and describes the critical care nurse's essential role in selecting and monitoring intravenous fluid therapy.©2020 American Association of Critical-Care Nurses.

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