ECI 2015: Fluid Resuscitation

This 15 minute talk was given at the Emergency Care Symposium 2015 for the Emergency Care Institute

Slides:

References:
The three ‘R’s of fluid prescription:
Minto G, Mythen MG. Perioperative fluid management: science, art or random chaos?
Br J Anaesth. 2015 Mar 19.

The windows to the circulation: skin, brain, kidney
Cecconi M, De Backer D, Antonelli M, Beale R, Bakker J, Hofer C, et al. Consensus on circulatory shock and hemodynamic monitoring. Task force of the European Society of Intensive Care Medicine.
Intensive Care Med. 2014 Nov 13;40(12):1795–815.

0.9% Saline
Why high sodium concentrations in resuscitation fluid is good:
Lunøe M, Overgaard-Steensen C. Prevention of hospital-acquired hyponatraemia: individualised fluid therapy.
Acta Anaesthesiologica Scandinavica. 2015 May 9;59(8):975–85.

Why high chloride concentrations might not be so good:
http://resus.me/whats-with-all-the-chloride-an-assault-on-salt/

Why it might not matter on ICU:
Young P, Bailey M, Beasley R, Henderson S, Mackle D, McArthur C, et al. Effect of a Buffered Crystalloid Solution vs Saline on Acute Kidney Injury Among Patients in the Intensive Care Unit.
JAMA. 2015 Oct 7;:1.

Hartmann’s
Why we needn’t worry about the lactate content:
White SA, Goldhill DR. Is Hartmann’s the solution?
Anaesthesia. 1997 May;52(5):422–7.

Why we needn’t worry about the potassium content:
O Malley CMN, Frumento RJ, Hardy MA, Benvenisty AI, Brentjens TE, Mercer JS, et al. A Randomized, Double-Blind Comparison of Lactated Ringer’s Solution and 0.9% NaCl During Renal Transplantation.
Anesth Analg. 2005 May;100(5):1518–24.

Cutting Edge Resuscitation Medical Education