Fluid Stewardship During Critical Illness: A Call to Action

• DOI: 10.1177/0897190019853979
• Publication Date: 2019-07-01T04:00:26Z
• Authors: W. Anthony Hawkins; Susan E. Smith; Andrea Sikora New...; John R. Carr; Christopher M. Bland; Trisha N. Branan
• Keywords: Hypervolemia; Organ dysfunction

Intravenous fluids (IVFs) are the most common drugs administered in intensive care unit. Despite ubiquitous use, IVFs not benign and carry significant risks associated with under- or overadministration. Hypovolemia is decreased organ perfusion, ischemia, multi-organ failure. Hypervolemia volume overload dysfunction, delayed liberation from mechanical ventilation, increased mortality. appropriate provision of IVF, adverse drug effects such as electrolyte abnormalities acid–base disturbances may occur. The management status critically ill patients both dynamic tenuous, a process that requires frequent monitoring high clinical acumen. Because patient-specific considerations for fluid therapy evolve across continuum critical illness, standard approach to assessment needs prescription IVF necessary. We propose principle “fluid stewardship,” guided by 4 rights medication safety: right patient, drug, route, dose. successful implementation stewardship will aid pharmacists making decisions regarding optimize hemodynamic improve patient outcomes. Additionally, we highlight several areas focus future research, construct stewardship.