title: Fluid management in the cardiothoracic intensive care unit: diuresis--diuretics and hemofiltration.
abstract: OBJECTIVE
  The present review discusses the current concepts of fluid management in cardiothoracic surgery, and its clinical implications with special reference to organ-related complications and their prevention.
  
  
  RESULTS
  Current strategies in fluid management for cardiothoracic patients, various fluid formulation, and the preventive strategies for minimizing fluid-related complications are described, with particular reference to new discoveries and controversies that have arisen from recent literature.
  
  
  CONCLUSIONS
  The optimal fluid management in cardiothoracic patients has not been settled. Results of recent clinical published trials highlight the need for minimizing fluid administration and attempting to use diuretics to achieve a negative fluid, although hypovolemia and hypoperfusion should be carefully considered. An individualized optimization of fluid status, using goal-directed therapy, has emerged as a possible preferable approach. The old debate between crystalloid and colloid solutions has been partially solved, as some colloids have demonstrated deleterious effect on renal function and coagulation system. Various preventive strategies have also emerged for minimizing fluid-related complications.
authors: aDepartment of Heart and Vessels, Cardiac Surgery Unit, Varese bDepartment of Cardiac Surgery and Transplantation, S. Camillo Hospital, Rome, Italy.
authors: Giovanni
authors: G
authors: Mariscalco
authors: Francesco
authors: F
authors: Musumeci
mesh_terms: D003102:Colloids / Q000627:therapeutic use; D000077324:Crystalloid Solutions; D004231:Diuresis; D004232:Diuretics / Q000627:therapeutic use*; D005440:Fluid Therapy / Q000009:adverse effects / Q000379:methods*; D006440:Hemofiltration; D006801:Humans; D007362:Intensive Care Units; D007552:Isotonic Solutions / Q000627:therapeutic use; D017582:Renal Replacement Therapy
chemical_list: D003102:Colloids; D000077324:Crystalloid Solutions; D004232:Diuretics; D007552:Isotonic Solutions