title: Guiding principles of fluid and volume therapy.
abstract: Fluid therapy is a core concept in the management of perioperative and critically ill patients for maintenance of intravascular volume and organ perfusion. Recent evidence regarding the vascular barrier and its role in terms of vascular leakage has led to a new concept for fluid administration. The choice of fluid used should be based on the fluid composition and the underlying pathophysiology of the patient. Avoidance of both hypo- and hypervolaemia is essential when treating circulatory failure. In daily practice, the assessment of individual thresholds in order to optimize cardiac preload and avoid hypovolaemia or deleterious fluid overload remains a challenge. Liberal versus restrictive fluid management has been challenged by recent evidence, and the ideal approach appears to be goal-directed fluid therapy.
authors.affiliation: Head of Emergency Intensive Care Unit, Cipto Mangunkusumo Hospital, Diponegoro St. no. 71, Central Jakarta City, 10430, Indonesia; Department of Anaesthesia and Intensive Care, University of Indonesia, Jakarta, Indonesia. Electronic address: ditaaditia@yahoo.com.
authors.forename: Dita
authors.initials: D
authors.lastname: Aditianingsih
authors.affiliation: Head of Emergency and Intensive Care Unit, Pondok Indah Hospital, Metroduta Kav UE, South Jakarta City, 12310, Indonesia; Department of Anaesthesia and Intensive Care, University of Indonesia, Jakarta, Indonesia.
authors.forename: Yohanes W H
authors.initials: YW
authors.lastname: George
mesh_terms: D000818:Animals; D001810:Blood Volume / Q000187:drug effects / Q000502:physiology*; D016638:Critical Illness / Q000628:therapy*; D019468:Disease Management; D005440:Fluid Therapy / Q000379:methods*; D006801:Humans; D018805:Sepsis / Q000097:blood / Q000628:therapy*
keywords: colloids; crystalloids; goal-directed fluid therapy; liberal versus restrictive fluid management; preload responsiveness; ‘double-barrier concept’