BioMed Research International / 2015 / Article / Tab 1

Review Article

Fluid Therapy: Double-Edged Sword during Critical Care?

Table 1

The risks of excessive fluid load.

SettingsAdverse effectComment

PerioperativeHyperchloremia and dilutional acidosisCan be reduced using anion-balanced crystalloid solutions
Reduced rate of wound healingCan be related to the peripheral tissue edema
Increased risk of anastomosis leakageIntestinal edema and decreased splanchnic perfusion
Increased IAPIntestinal and abdominal wall edema
Increased risk of respiratory complicationsPulmonary and chest wall edema. Stressfully increased work of breathing

ICUGIPS and glycocalyx injuryThe decrease of subglycocalyx oncotic pressure facilitates the capillary leakage
Increased IAP/ACS and polycompartment syndromeCan be associated with polycompartment syndrome resulting in AKI, liver dysfunction, FRC reduction, and ileus
Deranged oxygenation, pulmonary and chest wall edema, incidence, or increased ARDS severityEVLWI increase. The fluid load is an independent risk factor of ARDS
EnteropathyGut edema, bacterial translocation, malabsorption, and liver congestion
Brain edema and increased ICPAlbumin is risky
Kidney injuryEdema of kidney parenchyma with increase of and decreased GFR
Myocardial injuryDilatation, ANP release, and myocardium edema associated with diastolic dysfunction (relaxation) and blockade
Increased mortality

IAP: intraabdominal pressure, ICP: intracranial pressure, ACS: abdominal compartment syndrome, GIPS: global increased permeability syndrome, ANP: atrial natriuretic peptide, ARDS: acute respiratory distress syndrome, EVLWI: extravascular lung water index, and GFR: glomerular filtration rate.