Full Description
This open access book, published by Springer under the Open Access CC BY 4.0 Licence in collaboration with the International Fluid Academy (IFA, www.fluidacademy.org), explores rationalized intravenous fluid therapy for critically ill patients. Despite being commonly prescribed in inpatient settings, intravenous fluids are often administered without evidence-based guidelines, neglecting essential considerations such as the fact they are drugs, that need proper dosing, duration, indications, contraindications, side effects, and de-escalation. This book fills this knowledge gap.
Each chapter starts with a clinical vignette and a related question, followed by a concise summary abstract, key learning points, main text, and a conclusion that addresses the clinical question and provides relevant take-home messages. Additionally, every chapter includes an IFA commentary referencing the latest literature and evidence. The book begins with an introductory chapter that provides definitions and terminology, followed by four sections.
The first section covers the fundamentals of intravenous fluid therapy, including fluid compartments in sick patients, fluid bolus dynamics, heart-lung interactions, fluid challenge, fluid responsiveness, arterial blood gas analysis based on traditional and Stewart concepts, and electrolyte physiology relevant to clinical issues. The second section discusses commercially available intravenous fluids, while the third section focuses on fluid therapy in specific clinical situations. The final section introduces the concepts of fluid stewardship and appropriate fluid prescription.
Aligned with the International Fluid Academy's mission to enhance education and promote research on fluid management and monitoring, ultimately improving patient survival rates, this book contributes significantly to establishing fluid stewardship at the bedside. It provides valuable support for physicians, nurses, pharmacists, and other healthcare professionals across various clinical disciplines working in emergency rooms, operating rooms, or intensive care units, aiding their everyday clinical practice.
Contents
Part I. Fundamentals of Intravenous Fluid Therapy.- Terms and Definitions on Fluid Therapy.- Fluid Physiology Part 1: Volume and Distribution of Water and its Major Solutes between Plasma, the Interstitium and Intracellular Fluids.- Fluid Physiology Part 2: Regulation of Body Fluids and the Distribution of Infusion Fluids.- Fluid Dynamics during Resuscitation: from Frank-Starling to the Reappraisal of Guyton.- Understanding Heart-Lung Interactions: Concepts of Fluid Responsiveness and the Place for the Fluid Challenge.- Traditional Approach to Acid Base.- Stewart Approach to Acid Base.- The 4 indications of Fluid Therapy: Resuscitation, Replacement, Maintenance, Nutrition Fluids and Beyond.- Part II. Commercially Available Intravenous Fluids.- The Place for Crystalloids.- The Case for Albumin as Volume Expander and Beyond.- The Place for Starches and Other Colloids.- How to Use Blood and Blood Products.- Nutrition Delivery in Critically Ill Patients.- Part III. Fluid Therapy inSpecial Conditions.- Fluid Management in Septic Shock.- Fluid Management in Cardiogenic Shock.- Fluid Management in Trauma Patients.- Fluid Management in Neurocritical Care.- Perioperative Fluid Management.- Fluid Management in Major Burns.- Fluid Management in Pediatric Patients.- Fluid Management in Liver Failure.- Fluid Management in Abdominal Hypertension.- Disorders of Sodium and Chloride Balance.- Balanced Solutions: Choice of Buffer.- De-resuscitation: Rationale and Practical Approach.- Fluid Management in COVID-19.- Part IV. Concepts of Fluid Stewardship and Appropriate Fluid Prescription.- Introduction to Fluid Stewardship.- A Logical Prescription of Intravenous Fluids.
