Intravenous fluid treatment is one of the most common procedures in patients with acute conditions. More than 20% of patients with intensive care receive intravenous resuscitation daily and more than 30% receive fluid resuscitation on the first day of the intensive care unit. Almost all hospitalized patients are given intravenous fluid to maintain fluid intake and as a diluent for drug administration. Until recently, the amount and type of injected fluids was based on a theory created over 100 years ago and was largely incompatible with current physiological data and new data. Despite their widespread use, various intravenous fluids have loaded clinical practice without a reliable assessment of their safety and efficacy. High quality studies initiated by studies have shown that some of these fluids have unacceptable toxicity. As a result, some of them were taken out of the market (while others are still used in disputes). The suggestion that dehydration and hypovolaemia can damage or aggravate the kidneys and other vital organs has led to liberal approaches to fluid treatment and the fact that fluid overload and tissue swelling are „normal” in severe diseases. It can harm the patient. Increasing evidence suggests that restrictive fluid strategies can improve results.
Important points:
Intravenous fluid management is one of the most common procedures in the emergency and intensive care units, but the underlying physiological theory is largely incorrect.
Intravenous fluids have been made in clinical practice and approved for use without a thorough evaluation of their efficacy or safety, although high quality studies initiated by scientists now provide such data.
For first-line treatment, crystalloid fluids should be used. In most patients, buffered saline solutions appear to have advantages over normal saline.
Administration of albumin may be beneficial in patients with sepsis, cirrhosis or infection, but albumin in a hypotonic carrier fluid is contraindicated in patients with acute traumatic brain injury.
Synthetic colloids, especially hydroxyethyl starch and gelatins, should not be used because of their unacceptable safety profile and lack of proven benefits over crystalloids.
Liquid restriction strategies can reduce morbidity and mortality. But more extensive studies are required to confirm these promising basic data.