Context-sensitive fluid therapy in critical illness

摘要: Microcirculatory alterations are frequently observed in critically ill patients undergoing major surgery and those who suffer from trauma or sepsis. Despite the need for adequate fluid administration to restore microcirculation, there is no consensus regarding optimal therapy these patients. The recent recognition of importance endothelial glycocalyx layer capillary solute exchange has largely changed our views on critical illness. Given that disease status differs among patients, must not be considered generally, but rather tailored clinical condition each patient. This review outlines current understanding context-sensitive volume expansion by solutions considers its implications modulation hydrostatic pressure through appropriate use vasopressors may increase effectiveness infusion thereby reduce detrimental effects resulting excessive administration.