title: Fluid Overload.
abstract: Most critically ill patients experience external or internal fluid shifts and hemodynamic instability. In response to these changes, intravenous fluids are frequently administered. However, rapid losses of administered fluids from circulation and the indirect link between the short-lived plasma volume expansion and end points frequently result in transient responses to fluid therapy. Therefore, fluid overload is a common finding in intensive care units. The authors consider the evidence of harm associated with fluid overload and the physiologic processes that lead to fluid accumulation in critical illness. The authors then consider methods to prevent fluid accumulation and/or manage its resolution.
authors.affiliation: Adult Critical Care Unit, The Royal London Hospital, Barts Health NHS Trust, Whitechapel Road, London E1 1BB, UK; Centre for Translational Medicine & Therapeutics, William Harvey Research Institute, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK.
authors.forename: Michael E
authors.initials: ME
authors.lastname: O'Connor
authors.affiliation: Adult Critical Care Unit, The Royal London Hospital, Barts Health NHS Trust, Whitechapel Road, London E1 1BB, UK; Centre for Translational Medicine & Therapeutics, William Harvey Research Institute, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK; Department of Renal and Transplant Medicine, The Royal London Hospital, Barts Health NHS Trust, Whitechapel Road, London E1 1BB, UK. Electronic address: j.prowle@qmul.ac.uk.
authors.forename: John R
authors.initials: JR
authors.lastname: Prowle
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology; D003422:Critical Care; D016638:Critical Illness; D004232:Diuretics / Q000627:therapeutic use; D045604:Extracellular Fluid; D005440:Fluid Therapy / Q000009:adverse effects* / Q000379:methods*; D006440:Hemofiltration; D006801:Humans; D008991:Monitoring, Physiologic; D011654:Pulmonary Edema / Q000209:etiology / Q000503:physiopathology*; D014882:Water-Electrolyte Balance; D014883:Water-Electrolyte Imbalance / Q000209:etiology / Q000503:physiopathology* / Q000628:therapy
chemical_list: D004232:Diuretics
keywords: Critical illness; Diuretics; Edema; Fluid overload; Ultrafiltration