Water, taken in moderation, cannot hurt anybody (Mark Twain 1835-1910).

摘要

Few areas of clinical practice arouse such strong feeling as intra-venous fluid therapy. For many years clinicians have hotly debated both the type and dose of intra-venous fluids they should use. In many cases fluid therapy is required simply to meet maintenance requirements. These can be estimated from body mass with acceptable accuracy and there is general agreement regarding the optimal approach. Greater controversy surrounds the treatment of patients with fluid deficits. Trauma, major surgery and severe sepsis are common causes of life threatening reductions in plasma volume. In some cases fluid deficit may be reliably estimated, but this is not usually possible and clinicians must use more subjective criteria. Consequently, such patients are at risk of the adverse effects of either inadequate or excessive fluid administration.