Balanced volume replacement strategy: Fact or fiction?

Abstract

Adequate volume restoration in the hypovolemic patient appears to be essential to stave non-compensatory, irreversible shock and subsequently to avoid development of multiple organ dysfunction syndrome. Vigorous optimization of the circulation is a prerequisite in the management of such patients. This maneuver is aimed at guaranteeing stable macro- and micro-hemodynamics, while avoiding excessive fluid accumulation in the interstitial tissue. The choice of fluid for this purpose engenders considerable controversy and there is still a dispute over the beneficial and adverse effects of each fluid type. © 2007 Springer Science + Business Media Inc.