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MEDIN-1603; No. of Pages 11 ARTICLE IN PRESS
Med Intensiva. 2020;xxx(xx):xxx---xxx
http://www.medintensiva.org/
REVIEW
Ten answers to key questions for fluid management in
intensive care
F. Sanfilippo a,∗ , A. Messina b,c , M. Cecconi b,c , M. Astuto a,d,e
a
Department of Anaesthesia and Intensive Care, A.O.U. ‘‘Policlinico-Vittorio Emanuele’’, Catania, Italy
b
Humanitas Clinical and Research Center --- IRCCS, Milano, Italy
c
Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, MI, Italy
d
School of Anaesthesia and Intensive Care, University Hospital ‘‘G. Rodolico’’, University of Catania, Catania, Italy
e
Department of General Surgery and Medical-Surgical Specialties, Section of Anesthesia and Intensive Care, University of
Catania, Catania, Italy
Received 27 July 2020; accepted 17 October 2020
KEYWORDS Abstract This review focuses on fluid management of critically ill patients. The topic is
Sepsis; addressed based on 10 single questions with simplified answers that provide clinicians with
Septic shock; the basic information needed at the point of care in treating patients in the Intensive Care
Hemodynamic Unit. The review has didactic purposes and may serve both as an update on fluid management
monitoring; and as an introduction to the subject for novices in critical care.
Echocardiography; There is an urgent need to increase awareness regarding the potential risks associated with
Crystalloids; fluid overload. Clinicians should be mindful not only of the indications for administering fluid
Colloids loads and of the type of fluids administered, but also of the importance to set safety limits.
Lastly, it is important to implement proactive strategies seeking to establish negative fluid
balance as soon as the clinical conditions are considered to be stable and the risk of deterioration
is low.
© 2020 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.
PALABRAS CLAVE Diez respuestas a preguntas clave para el manejo de fluidos en cuidados intensivos
Sepsis;
Shock séptico; Resumen Esta revisión se centra en el manejo de fluidos en el paciente crítico. Discutimos
Monitoreo el tema con un enfoque basado en 10 preguntas individuales con respuestas simplificadas, que
hemodinámico; ofrecen al personal clínico la información básica necesaria, a pie de cama, para tratar a los
Ecocardiografía; pacientes en las unidades de cuidados intensivos. Esta revisión tiene propósitos didácticos y
Cristaloides; puede servir tanto como actualización sobre el manejo de fluidos como una introducción al
Coloides tema para los que comienzan a tratar a pacientes críticos.
∗ Corresponding author.
E-mail address: filipposanfi@yahoo.it (F. Sanfilippo).
https://doi.org/10.1016/j.medin.2020.10.005
0210-5691/© 2020 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.
Please cite this article in press as: Sanfilippo F, et al. Ten answers to key questions for fluid management in intensive
care. Med Intensiva. 2020. https://doi.org/10.1016/j.medin.2020.10.005
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Medicina intensiva, Corrected proof. doi:10.1016/j.medin.2020.10.005
