Current opinion in critical care
-
We discuss the goals of resuscitation, in both the early and the later phases, measures of organ perfusion, fluid responsiveness and the consequences of tissue edema. ⋯ Rapid diagnosis and early fluid resuscitation are crucial to patients with septic shock, initially with the primary goal to relieve the overt tissue hypoxia. Early fluid therapy is important with the caveat that patients must show an increase in their cardiac output. Beyond 6-12 h further positive fluid balance may not usefully improve tissue oxygenation and may be counterproductive.
-
To review the past year's literature, and selected prior literature relevant to these most recent findings, regarding intravenous fluid choices in the management of critically ill children. ⋯ Because intravenous fluid can be helpful or harmful, it can only be safely done in critically ill children when using state-of-the-art monitoring of patient volume, electrolyte, osmolarity, pH, and glucose status.