Please use this identifier to cite or link to this item: http://ahro.austin.org.au/austinjspui/handle/1/11055
Title: Fluid administration and the kidney.
Authors: Prowle, John R;Bellomo, Rinaldo
Affiliation: Department of Intensive Care, Austin Health, Heidelberg, Victoria, Australia
Issue Date: 1-Aug-2010
Citation: Current Opinion in Critical Care; 16(4): 332-6
Abstract: Intravenous fluids are widely administered in the ICU with the intention of preventing or ameliorating acute kidney injury (AKI). This review focuses on recent studies examining fluid administration and renal function in critical illness to critically examine conventional justifications for fluid administration.Early, targeted, resuscitation of inadequate cardiac output in shock may have a beneficial effect on organ function and patient outcome. However, experimental evidence suggests the relationship between fluid administration and an increase in renal oxygen delivery is weak, whereas any beneficial effects from fluid administration can be short lived. Conversely, evidence associating fluid overload and adverse outcomes is strengthening, whereas more restrictive fluid administration does not seem to predispose to clinically significant AKI in many situations. Furthermore, concerns persist that some colloid or high chloride concentration solutions may directly impair renal function independent of volume overload.Adequate volume resuscitation remains a cornerstone to the emergent treatment of critical illness. However, continued fluid administration and positive fluid balances have not been shown to improve renal outcomes and may worsen overall prognosis in AKI. Concerns about renal dysfunction should not deter clinicians from adopting more restrictive approaches to fluid administration.
Internal ID Number: 20543683
URI: http://ahro.austin.org.au/austinjspui/handle/1/11055
DOI: 10.1097/MCC.0b013e32833be90b
URL: http://www.ncbi.nlm.nih.gov/pubmed/20543683
Type: Journal Article
Subjects: Cardiac Output
Critical Care.methods
Critical Illness
Fluid Therapy.methods
Glomerular Filtration Rate
Hemodynamics
Humans
Infusions, Intravenous.methods
Intensive Care Units
Isotonic Solutions.administration & dosage
Kidney.physiology
Prognosis
Shock, Cardiogenic.prevention & control
Appears in Collections:Journal articles

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