Fluid resuscitation among the critically ill: more water under the bridge

摘要

Background: Critically ill patients require supplementary iv fluids to support vital functions. Crystalloids and colloids (naturally-occurring and synthetic) are frequently used for fluid, support. The choice of the type of fluid used on mortality among the critically ill remains controversial, as the effect of this choice remains unknown. Design: Multicentre prospective blinded randomized controlled trial. Patients: 6,997 critically ill patients requiring fluid supplementation because of hemodynamic abnormalities including any of: tachycardia (heart rate > 90), hypotension (systolic pressure < 100 or mean arterial pressure < 75), need for vasoactive medications, oliguria, or delayed capillary refill. The study size had 90% power to detect a 3% difference in mortality between groups.