fluidresuscitation

Fluid resuscitation is the medical practice of rapidly administering intravenous fluids to restore circulating volume and tissue perfusion in patients with hypovolemia or shock. The objective is to resume adequate mean arterial pressure and organ perfusion while avoiding fluid overload and related complications. It is used in contexts such as hemorrhage, sepsis, major trauma, dehydration, burns, pancreatitis, and postoperative states.

Fluids commonly employed include crystalloids (isotonic solutions such as normal saline and balanced solutions like Ringer's lactate or Plasma-Lyte) and, less routinely, colloids (such as albumin). In most acute resuscitations, isotonic crystalloids are given as boluses (for example, 250–500 mL in adults) with repeated reassessment after each bolus. In sepsis and septic shock, guidelines advocate prompt crystalloids early in resuscitation, with ongoing assessment and vasopressor support if hypotension persists after fluid administration. In hemorrhagic shock, fluid resuscitation is coordinated with blood product transfusion and damage-control strategies; permissive hypotension may be considered in selected patients to control bleeding before definitive care. Monitoring relies on vital signs, urine output, lactate clearance, and repeated assessment of fluid responsiveness using dynamic tests when feasible. Central venous pressure and other static measures are less reliable guides on their own.

Complications include fluid overload, pulmonary edema, electrolyte disturbances, and acid-base abnormalities, particularly with large volumes of saline. Fluid choice and volume should be tailored to the patient’s comorbidities, age, and clinical trajectory.