Fluid challenge revisited.
OBJECTIVE
To discuss the rationale, technique, and clinical application of the fluid challenge.


METHODS
Relevant literature from MEDLINE and authors' personal databases.


METHODS
Studies on fluid challenge in the acutely ill.


METHODS
Based largely on clinical experience and assessment of the relevant published literature, we propose that the protocol should include four variables, namely 1) the type of fluid administered, 2) the rate of fluid administration, 3) the critical end points, and 4) the safety limits.


CONCLUSIONS
A protocol for routine fluid challenge is proposed with defined rules and based on the patient's response to the volumes infused. The technique allows for prompt correction of fluid deficits yet minimizes the risks of fluid overload.


OBJECTIVE
On completion of this article, the reader should be able to: 1. Explain the signs of hypovolemia. 2. Describe how to administer a fluid challenge. 3. Use this information in a clinical setting.
Vincent
Jean-Louis
JL
Department of Intensive Care, Erasme Hospital, Free University of Brussels, Belgium.
Weil
Max Harry
MH
D002496:Central Venous Pressure; D003422:Critical Care; D005440:Fluid Therapy / Q000379:methods*; D006801:Humans; D012151:Resuscitation