Fluids in the ICU: Which is the Right One?

Overview

Journal Nephrol Dial Transplant

Publisher Oxford University Press

Specialties General Surgery
Nephrology

Date 2022 Sep 28

PMID 36170962

Authors

Timo Mayerhofer

Andrew D Shaw

Christian J Wiedermann

Michael Joannidis

Affiliations

Soon will be listed here.

Abstract

The administration of fluids is one of the most common interventions in the intensive care unit. The effects and side effects of intravenous fluids depend on the amount administered and their specific composition. Intravenous fluid solutions are either considered crystalloids (for example 0.9% saline, lactated Ringer's solution) or colloids (artificial colloids such as gelatins, and albumin). This narrative review summarizes the physiological principles of fluid therapy and reviews the most important studies on crystalloids, artificial colloids and albumin in the context of critically ill patients.

Citing Articles

[Volume therapy: which preparation for which situation?].

Mayerhofer T, Lehner G, Joannidis M Med Klin Intensivmed Notfmed. 2024; 119(8):640-649.

PMID: 39382683 PMC: 11538216. DOI: 10.1007/s00063-024-01194-0.

[Recent developments in acute kidney injury : Definition, biomarkers, subphenotypes, and management].

Mayerhofer T, Perschinka F, Joannidis M Med Klin Intensivmed Notfmed. 2024; 119(5):339-345.

PMID: 38683229 PMC: 11130018. DOI: 10.1007/s00063-024-01142-y.

Challenging the common practice of intravenous fluid administration : Viewpoint on the need for an enteral fluid therapy trial in critically ill patients.

Keil N, Rathkolb V, Waller M, Krenn S, Hinterholzer G, Druml W Wien Klin Wochenschr. 2024; 136(23-24):647-650.

PMID: 38456939 PMC: 11632051. DOI: 10.1007/s00508-024-02335-3.

Normal saline: Past, present, and future.

Liu X, Lu M Sci Prog. 2023; 106(2):368504231168821.

PMID: 37073583 PMC: 10450286. DOI: 10.1177/00368504231168821.

Moderator Effect of Hypoalbuminemia in Volume Resuscitation and Plasma Expansion with Intravenous Albumin Solution.

Wiedermann C Int J Mol Sci. 2022; 23(22).

PMID: 36430652 PMC: 9695189. DOI: 10.3390/ijms232214175.

References

Singer P, Reintam Blaser A, Berger M, Alhazzani W, Calder P, Casaer M . ESPEN guideline on clinical nutrition in the intensive care unit. Clin Nutr. 2018; 38(1):48-79. DOI: 10.1016/j.clnu.2018.08.037. View

Philips C, Maiwall R, Sharma M, Jindal A, Choudhury A, Kumar G . Comparison of 5% human albumin and normal saline for fluid resuscitation in sepsis induced hypotension among patients with cirrhosis (FRISC study): a randomized controlled trial. Hepatol Int. 2021; 15(4):983-994. DOI: 10.1007/s12072-021-10164-z. View

Shin C, Long D, McLean D, Grabitz S, Ladha K, Timm F . Effects of Intraoperative Fluid Management on Postoperative Outcomes: A Hospital Registry Study. Ann Surg. 2017; 267(6):1084-1092. DOI: 10.1097/SLA.0000000000002220. View

Woodcock T, Woodcock T . Revised Starling equation and the glycocalyx model of transvascular fluid exchange: an improved paradigm for prescribing intravenous fluid therapy. Br J Anaesth. 2012; 108(3):384-94. DOI: 10.1093/bja/aer515. View

Hammond N, Zampieri F, Di Tanna G, Garside T, Adigbli D, Cavalcanti A . Balanced Crystalloids versus Saline in Critically Ill Adults - A Systematic Review with Meta-Analysis. NEJM Evid. 2024; 1(2):EVIDoa2100010. DOI: 10.1056/EVIDoa2100010. View

Shahid A, Fanapour P, Gazmuri R . Restriction of Intravenous Fluid in ICU Patients with Septic Shock. N Engl J Med. 2022; 387(9):856. DOI: 10.1056/NEJMc2210366. View

Semler M, Self W, Wanderer J, Ehrenfeld J, Wang L, Byrne D . Balanced Crystalloids versus Saline in Critically Ill Adults. N Engl J Med. 2018; 378(9):829-839. PMC: 5846085. DOI: 10.1056/NEJMoa1711584. View

Nunes T, Ladeira R, Bafi A, de Azevedo L, Machado F, Freitas F . Duration of hemodynamic effects of crystalloids in patients with circulatory shock after initial resuscitation. Ann Intensive Care. 2015; 4:25. PMC: 4273721. DOI: 10.1186/s13613-014-0025-9. View

Finfer S, Bellomo R, Boyce N, French J, Myburgh J, Norton R . A comparison of albumin and saline for fluid resuscitation in the intensive care unit. N Engl J Med. 2004; 350(22):2247-56. DOI: 10.1056/NEJMoa040232. View

10.

Moeller C, Fleischmann C, Thomas-Rueddel D, Vlasakov V, Rochwerg B, Theurer P . How safe is gelatin? A systematic review and meta-analysis of gelatin-containing plasma expanders vs crystalloids and albumin. J Crit Care. 2016; 35:75-83. DOI: 10.1016/j.jcrc.2016.04.011. View

11.

Jozwiak M, Silva S, Persichini R, Anguel N, Osman D, Richard C . Extravascular lung water is an independent prognostic factor in patients with acute respiratory distress syndrome. Crit Care Med. 2012; 41(2):472-80. DOI: 10.1097/CCM.0b013e31826ab377. View

12.

Finfer S, Micallef S, Hammond N, Navarra L, Bellomo R, Billot L . Balanced Multielectrolyte Solution versus Saline in Critically Ill Adults. N Engl J Med. 2022; 386(9):815-826. DOI: 10.1056/NEJMoa2114464. View

13.

Self W, Semler M, Wanderer J, Wang L, Byrne D, Collins S . Balanced Crystalloids versus Saline in Noncritically Ill Adults. N Engl J Med. 2018; 378(9):819-828. PMC: 5846618. DOI: 10.1056/NEJMoa1711586. View

14.

Moore P, Hsu R, Liu K . Management of Acute Kidney Injury: Core Curriculum 2018. Am J Kidney Dis. 2018; 72(1):136-148. DOI: 10.1053/j.ajkd.2017.11.021. View

15.

Zampieri F, Machado F, Biondi R, Freitas F, Veiga V, Figueiredo R . Association between Type of Fluid Received Prior to Enrollment, Type of Admission, and Effect of Balanced Crystalloid in Critically Ill Adults: A Secondary Exploratory Analysis of the BaSICS Clinical Trial. Am J Respir Crit Care Med. 2022; 205(12):1419-1428. DOI: 10.1164/rccm.202111-2484OC. View

16.

Milford E, Reade M . Resuscitation Fluid Choices to Preserve the Endothelial Glycocalyx. Crit Care. 2019; 23(1):77. PMC: 6408751. DOI: 10.1186/s13054-019-2369-x. View

17.

Sakr Y, Rubatto Birri P, Kotfis K, Nanchal R, Shah B, Kluge S . Higher Fluid Balance Increases the Risk of Death From Sepsis: Results From a Large International Audit. Crit Care Med. 2016; 45(3):386-394. DOI: 10.1097/CCM.0000000000002189. View

18.

Bellmann R, Feistritzer C, Wiedermann C . Effect of molecular weight and substitution on tissue uptake of hydroxyethyl starch: a meta-analysis of clinical studies. Clin Pharmacokinet. 2012; 51(4):225-36. DOI: 10.2165/11594700-000000000-00000. View

19.

China L, Freemantle N, Forrest E, Kallis Y, Ryder S, Wright G . A Randomized Trial of Albumin Infusions in Hospitalized Patients with Cirrhosis. N Engl J Med. 2021; 384(9):808-817. DOI: 10.1056/NEJMoa2022166. View

20.

Hammond N, Taylor C, Finfer S, Machado F, An Y, Billot L . Patterns of intravenous fluid resuscitation use in adult intensive care patients between 2007 and 2014: An international cross-sectional study. PLoS One. 2017; 12(5):e0176292. PMC: 5428917. DOI: 10.1371/journal.pone.0176292. View