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Colegio de Medicina Interna de México.

2022, Number 3

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Med Int Mex 2022; 38 (3)

Fluid responsiveness in medical treatment: historic background and a review for accurate application

García-Regalado J, Padilla-Sandoval EA

Language: Spanish
References: 42
Page: 617-633
PDF size: 279.68 Kb.


ABSTRACT

Intravenous solution administration is a common medical practice. The only indication for administering intravenous solutions is to provoke an increase in the systolic volume of the heart by 10-15% posterior to the infusion. This concept is known as “fluid responder patient”. Nevertheless, such concept is not very well known yet, even among physicians who work in the emergency department, internal medicine hospital ward and intensive care unit. Unfortunately, the main indications for intravenous fluid administration are based on parameters that cannot predict such response (for example: physical examination, central venous pressure, base deficit, uresis). It has been shown that excessive fluid administration even during the early phase of reanimation may not only be resource consuming, but even deleterious for the patient. Besides, even when there are tools that are useful to assess when to stop hydric reanimation before facing its most feared complication (pulmonary lung edema), these are ignored and they are not commonly used. This may occur because they are not very known or because they are not considered very reliable, even though there is a great quantity of evidence that supports their utility in the clinical practice. We perform a review about the history of intravenous solutions, their indication and an approach to all physicians to the concept fluid responder.


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