Deep Dive: Fluid Resuscitation (Full)

Playlist: Deep Dive: Fluid Resuscitation3 Videos

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In her latest episode of ICU Fundamentals, Dr. Sara Crager reviews fluid resuscitation.

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Mat G. -

Maybe this will be a chart in part 2, but how does recruiting unstressed volume vary between pressors? Is one better suited than another? For example, I'm assuming neo is practically useless in this context.

Jonathon B. -

Also quite curious about this. As a corollary, this makes me think of use of Vaso in hepatic patients. Not sure if the mechanism is the same in such a context, but makes me wonder. Also, while we are challenging dogma -- would there be any reason to believe a different pressor than Levo may actually be more appropriate for the purposes of EARLY administration (i.e., before the currently accepted standards for what would be considered "adequate" fluid resuscitation)?

Noel N. -

So the ideal scenario would be to shift the Frank-Starling curve upward (difficult!), shift the fluid resistance curve to the right, and to be in the stressed volume part of the third curve. Wouldn't extra albumin work in favor of the two latter? The peer-reviewed evidence for this has been controversial (of course). Can't wait for Part 2!

Madeline D. -

This is a stellar lecture, thank you!

Ian L., Dr -

The 30ml/kg guideline started as for fluid loss from gastroenteritis and has been modified along the way for other conditions .The problem of reperfusion damage has great relevance in stroke management where the blood leaks out of vessels causing intracranial bleeding . -There it might be valuable to slow the blood flow drastically the vessels having opened up with anoxia to let something through .

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Mobile Video (180p) 741 MB - MP4Small Video (400p) 761 MB - MP4Standard Video (720p) 3.78 GB - MP4Deep Dive: Fluid Resuscitation (Vertical Video) 776 MB - MP4Fluid Resuscitation Part 1 (Vertical Video) 457 MB - MP4Fluid Resuscitation Part 2 (Vertical Video) 663 MB - MP4