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Critical care clinics · Apr 2018
ReviewApplied Physiology of Fluid Resuscitation in Critical Illness.
- Sabrina Arshed and Michael R Pinsky.
- Department of Critical Care Medicine, University of Pittsburgh, 1215.4 Kaufmann Medical Building, 3471 Fifth Avenue, Pittsburgh, PA 15213, USA.
- Crit Care Clin. 2018 Apr 1; 34 (2): 267-277.
AbstractFluids 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.Copyright © 2017 Elsevier Inc. All rights reserved.
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