2020年11月3日 · Positive fluid balance associated with mortality in AKI (SOAP study), slower recovery in ARDS (FACTT trial) and morbidity in colorectal surgery patients; AN APPROACH. Fluid bolus therapy, using small boluses with frequent reassessment, is reasonable in non-haemorrhagic hypovolaemic patients with evidence of hypoperfusion

2023年6月26日 · In pediatric patients, fluid resuscitation is indicated in the presence of hemorrhagic shock. An initial bolus of 20 mL/kg of either warmed 0.9% saline or lactated ringers is given. A repeat bolus of 20 mL/kg can be given if there is a transient or no response to initial bolus and then switch to resuscitation with blood products (10 mL/kg).

If patients need IV fluid resuscitation, use crystalloids that contain sodium in the range 130–154 mmol/l, with a bolus of 500 ml over less than 15 minutes. (For more information, see the Composition of commonly used crystalloids table.)

When the CVP is within the normal range, volume depletion cannot be excluded, and the response to 100- to 200-mL fluid boluses should be assessed; a modest increase in CVP in response to fluid generally indicates hypovolemia.

Identify cause of deficit and respond. Give a fluid bolus of 500 ml of crystalloid (containing sodium in the range of 130–154 mmol/l) over less than 15 minutes. Can the patient meet their fluid and/or electrolyte needs orally or enterally? clinical guideline 32).

2019年6月3日 · Lack of any sustained benefit from a fluid bolus is explained by rapid fluid extravasation out of the vasculature and into the tissues. Even among healthy volunteers who have been rendered hypovolemic , ~70% of a fluid bolus will extravasate into the tissues within merely 30 minutes!

When a condition of hypoperfusion has been identified, clinicians must decide whether fluids may increase blood flow or whether other therapeutic approaches are needed. For this purpose, several tests and parameters have been introduced in clinical practice to predict fluid responsiveness and guide therapy.

Intravenous maintenance fluid therapy consists of water and electrolytes to replace daily losses in ill children in whom enteral fluids are insufficient.

Fluid resuscitation is a limited opportunity to manipulate pH status. Large volumes of fluid can affect the patient's pH status. After the patient is volume resuscitated, this opportunity will be lost (because large volumes of fluid can no longer be given without causing volume overload).

Fluid bolus therapy (FBT) has long been the central component of resuscitation of children with sepsis (4). The role of FBT is to improve the circulating volume, cardiac output and mitigate circulatory dysfunction and organ hypoperfusion.