title: Rational fluid management in today's ICU practice.
abstract: Intravenous fluid therapy has evolved significantly over time. From the initial report of the first intravenous administration of sodium-chloride-based solution to the development of goal-directed fluid therapy using novel dynamic indices, efforts have focused on improving patient outcomes. The goal of this review is to provide a brief overview of current concepts for intravenous fluid administration in the ICU. Results of recently published clinical trials suggesting harmful effects of starch-based solutions on critically ill patients are discussed. Concepts for goal-directed fluid therapy and new modalities for the assessment of fluid status as well as for the prediction of responsiveness to different interventions will continue to emerge. Advances in technology will have to be critically evaluated for their ability to improve outcomes in different clinical scenarios.
authors.affiliation: Department of Anesthesiology, Box 3094, Suite 5670B, Duke University Medical Center, Durham, NC 27710, USA.
authors.forename: Karsten
authors.initials: K
authors.lastname: Bartels
authors.forename: Robert H
authors.initials: RH
authors.lastname: Thiele
authors.forename: Tong J
authors.initials: TJ
authors.lastname: Gan
mesh_terms: D003422:Critical Care / Q000379:methods*; D016638:Critical Illness / Q000628:therapy*; D005440:Fluid Therapy / Q000379:methods*; D006801:Humans; D007262:Infusions, Intravenous; D007362:Intensive Care Units / Q000458:organization & administration*; D017410:Practice Guidelines as Topic; D016896:Treatment Outcome