Direct markers of organ perfusion to guide fluid therapy: when to

Best Pract Res Clin Anaesthesiol · Sep 2014

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Direct markers of organ perfusion to guide fluid therapy: when to start, when to stop.

Up until now, the discussion in the literature as to the choice of fluids is almost completely restricted to the composition, with little to no attention paid to the importance of hemodynamic end points to achieve a desired optimal volume. The determination of fluid volume is left to the discretion of the attending physician with only surrogate markers as guidance the initiation and cessation of fluid therapy. In this article, we aim to discuss the available literature on existing clinical and experimental criteria for the initiation and cessation of fluid therapy. Furthermore, we present recent data that have become available after the introduction of direct in vivo microscopy of the microcirculation at the bedside, and discuss its potential influence on the existing paradigms and controversies in fluid therapy.

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- G Veenstra, C Ince, and E C Boerma.
- Department of Intensive Care, Erasmus MC University Hospital Rotterdam, Mailbox 2040, 3000 CA Rotterdam, The Netherlands. Electronic address: gerke52@gmail.com.
- Best Pract Res Clin Anaesthesiol. 2014 Sep 1;28(3):217-26.
AbstractUp until now, the discussion in the literature as to the choice of fluids is almost completely restricted to the composition, with little to no attention paid to the importance of hemodynamic end points to achieve a desired optimal volume. The determination of fluid volume is left to the discretion of the attending physician with only surrogate markers as guidance the initiation and cessation of fluid therapy. In this article, we aim to discuss the available literature on existing clinical and experimental criteria for the initiation and cessation of fluid therapy. Furthermore, we present recent data that have become available after the introduction of direct in vivo microscopy of the microcirculation at the bedside, and discuss its potential influence on the existing paradigms and controversies in fluid therapy. Copyright © 2014 Elsevier Ltd. All rights reserved.

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Direct markers of organ perfusion to guide fluid therapy: when to start, when to stop.

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