UMEM Educational Pearls

IV Fluid Resuscitation

  • IVF administration is one of the most common interventions in the resuscitation of critically ill patients.
  • The primary goals of IVFs are to augment cardiac output and increase O2 delivery.
  • The amount and type of IVF must take into account the patient's pathophysiology and type of shock.
  • Sepsis remains one of the most common causes of distributive shock in the ED and ICU.
  • Large volumes of IVF in sepsis often do not increase cardiac output and frequently lead to organ congestion.
  • Rather than a fixed dose, an individualized approach to IVFs in sepsis based on the patient's history, exam, labs, monitoring, and serial reassessments is likely to lead to better outcomes. 

References

Kaufman DA, et al. The ins and outs of IV fluids in hemodynamic resucitation. Crit Care Med. 2023;51:1397-1406.