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Early fluid resuscitation.
MedLine Citation:
PMID:  21308517     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Solid evidence exists that fluid therapy must be started as a first-line treatment in all patients with septic shock as soon as hypotension is detected, with the goal of rapidly restoring tissue perfusion. Crystalloids or colloids can be used for initial fluid therapy, and albumin should be reserved for patients with patent or supposed hypoalbuminemia. Once fluid administration is started, its effect must be carefully monitored. In the early stages, appropriate monitoring should ensure that fluid resuscitation actually increases cardiac preload, mean arterial pressure, and tissue oxygenation. In later stages, monitoring should help to avoid fluid overload. For this purpose, the end-point of fluid therapy should not be the static values of preload indicators, but rather the disappearance of indicators of preload responsiveness. Finally, the risk of fluid overload must always be kept in mind, especially in case of lung injury.
Authors:
Xavier Monnet; Jean-Louis Teboul
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Current infectious disease reports     Volume:  12     ISSN:  1534-3146     ISO Abbreviation:  Curr Infect Dis Rep     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2011-02-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100888983     Medline TA:  Curr Infect Dis Rep     Country:  United States    
Other Details:
Languages:  eng     Pagination:  354-60     Citation Subset:  -    
Affiliation:
Service de Réanimation Médicale, Hôpital de Bicêtre, 78, Rue du Général Leclerc, 94270, Le Kremlin-Bicêtre, France, xavier.monnet@bct.aphp.fr.
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