Rational Use of Intravenous Fluid in Critically Ill Patients

This book is published by Springer as open access under the Open Access CC BY 4.0 Licence and under the auspices of the International Fluid Academy (IFA, www.fluidacademy.org). It addresses and covers key aspects and fundamental elements of rationalized intravenous fluid therapy for critically ill patients. Intravenous fluids are one of the most commonly prescribed treatments in inpatient settings and are frequently administered without appropriate evidence-based guidelines. Despite their medicinal nature, they are often not fully recognized as drugs or medications, with accompanying considerations such as dosing, duration, indications, contraindications, potential side effects, and de-escalation. The book seeks to fill this knowledge gap.Each chapter in this book starts with a clinical vignette and a question that relates to the content of the chapter. This is followed by a brief summary abstract, key learning points, the main text, and a conclusion that answers the clinical question and summarizes the relevant take-home messages. Additionally, each chapter includes an IFA commentary that references the latest literature and evidence. The book commences with an introductory chapter that provides definitions and terminology, and is then divided into four sections. The first section covers the basics of intravenous fluid therapy, including traditional models of fluid compartments and their limitations in sick patients, fluid bolus dynamics, heart-lung interactions and their effects on fluid challenge and fluid responsiveness, traditional and Stewart concepts of arterial blood gas analysis, and electrolyte physiology related 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.In accordance with the mission statement of the International Fluid Academy, which aims to foster education and to promote research on fluid management and monitoring in critically ill and other patients, with the ultimate goal of improving patient survival rates, this volume makes a valuable contribution to establishing fluid stewardship at the bedside. The contents of the book will be useful for physicians, nurses, pharmacists, and other healthcare professionals from various clinical disciplines working at the bedside in the emergency room, operating room, or intensive care unit who require support for their everyday clinical practice.