Fluid resuscitation for acute kidney injury: An empty promise

Scott Watkins, Andrew D. Shaw

Research output: Contribution to journalReview article

Abstract

Purpose of review The past decade has seen more advances in our understanding of fluid therapy than the preceding decades combined. What was once thought to be a relatively benign panacea is increasingly being recognized as a potent pharmacological and physiological intervention that may pose as much harm as benefit. Recent findings Recent studies have clearly indicated that the amount, type, and timing of fluid administration have profound effects on patient morbidity and outcomes. The practice of aggressive volume resuscitation for 'renal protection' and 'hemodynamic support' may in fact be contributing to end organ dysfunction. The practice of early goal-directed therapy for patients suffering from critical illness or undergoing surgery appears to offer no benefit over conventional therapy and may in fact be harmful. A new conceptual model for fluid resuscitation of critically ill patients has recently been developed and is explored here. Summary The practice of giving more fluid early and often is being replaced with new conceptual models of fluid resuscitation that suggest fluid therapy be 'personalized' to individual patient pathophysiology.

Original languageEnglish (US)
Pages (from-to)527-532
Number of pages6
JournalCurrent Opinion in Critical Care
Volume22
Issue number6
DOIs
StatePublished - Nov 13 2016
Externally publishedYes

Keywords

  • Acute kidney injury
  • Early goal-directed fluid therapy
  • Fluid overload
  • Fluid resuscitation
  • Goal-directed fluid therapy

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

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