TY - JOUR
T1 - European Society of Intensive Care Medicine clinical practice guideline on fluid therapy in adult critically ill patients. Part 1
T2 - the choice of resuscitation fluids
AU - Arabi, Yaseen M
AU - Belley-Cote, Emilie
AU - Carsetti, Andrea
AU - De Backer, Daniel
AU - Donadello, Katia
AU - Juffermans, Nicole P
AU - Hammond, Naomi
AU - Laake, Jon Henrik
AU - Liu, Dawei
AU - Maitland, Kathryn
AU - Messina, Antonio
AU - Møller, Morten Hylander
AU - Poole, Daniele
AU - Mac Sweeney, Rob
AU - Vincent, Jean-Louis
AU - Zampieri, Fernando G
AU - AlShamsi, Fayez
AU - European Society of Intensive Care Medicine
N1 - © 2024. Springer-Verlag GmbH Germany, part of Springer Nature.
PY - 2024/6
Y1 - 2024/6
N2 - PURPOSE: This is the first of three parts of the clinical practice guideline from the European Society of Intensive Care Medicine (ESICM) on resuscitation fluids in adult critically ill patients. This part addresses fluid choice and the other two will separately address fluid amount and fluid removal.METHODS: This guideline was formulated by an international panel of clinical experts and methodologists. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology was applied to evaluate the certainty of evidence and to move from evidence to decision.RESULTS: For volume expansion, the guideline provides conditional recommendations for using crystalloids rather than albumin in critically ill patients in general (moderate certainty of evidence), in patients with sepsis (moderate certainty of evidence), in patients with acute respiratory failure (very low certainty of evidence) and in patients in the perioperative period and patients at risk for bleeding (very low certainty of evidence). There is a conditional recommendation for using isotonic saline rather than albumin in patients with traumatic brain injury (very low certainty of evidence). There is a conditional recommendation for using albumin rather than crystalloids in patients with cirrhosis (very low certainty of evidence). The guideline provides conditional recommendations for using balanced crystalloids rather than isotonic saline in critically ill patients in general (low certainty of evidence), in patients with sepsis (low certainty of evidence) and in patients with kidney injury (very low certainty of evidence). There is a conditional recommendation for using isotonic saline rather than balanced crystalloids in patients with traumatic brain injury (very low certainty of evidence). There is a conditional recommendation for using isotonic crystalloids rather than small-volume hypertonic crystalloids in critically ill patients in general (very low certainty of evidence).CONCLUSIONS: This guideline provides eleven recommendations to inform clinicians on resuscitation fluid choice in critically ill patients.
AB - PURPOSE: This is the first of three parts of the clinical practice guideline from the European Society of Intensive Care Medicine (ESICM) on resuscitation fluids in adult critically ill patients. This part addresses fluid choice and the other two will separately address fluid amount and fluid removal.METHODS: This guideline was formulated by an international panel of clinical experts and methodologists. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology was applied to evaluate the certainty of evidence and to move from evidence to decision.RESULTS: For volume expansion, the guideline provides conditional recommendations for using crystalloids rather than albumin in critically ill patients in general (moderate certainty of evidence), in patients with sepsis (moderate certainty of evidence), in patients with acute respiratory failure (very low certainty of evidence) and in patients in the perioperative period and patients at risk for bleeding (very low certainty of evidence). There is a conditional recommendation for using isotonic saline rather than albumin in patients with traumatic brain injury (very low certainty of evidence). There is a conditional recommendation for using albumin rather than crystalloids in patients with cirrhosis (very low certainty of evidence). The guideline provides conditional recommendations for using balanced crystalloids rather than isotonic saline in critically ill patients in general (low certainty of evidence), in patients with sepsis (low certainty of evidence) and in patients with kidney injury (very low certainty of evidence). There is a conditional recommendation for using isotonic saline rather than balanced crystalloids in patients with traumatic brain injury (very low certainty of evidence). There is a conditional recommendation for using isotonic crystalloids rather than small-volume hypertonic crystalloids in critically ill patients in general (very low certainty of evidence).CONCLUSIONS: This guideline provides eleven recommendations to inform clinicians on resuscitation fluid choice in critically ill patients.
KW - Adult
KW - Albumins/therapeutic use
KW - Critical Care/methods
KW - Critical Illness/therapy
KW - Crystalloid Solutions/administration & dosage
KW - Europe
KW - Fluid Therapy/methods
KW - Humans
KW - Resuscitation/methods
KW - Sepsis/therapy
KW - Albumin
KW - Critical care
KW - Fluid therapy
KW - Crystalloid solutions
KW - Practice guidelines
KW - Colloid solutions
UR - http://www.scopus.com/inward/record.url?scp=85193726158&partnerID=8YFLogxK
U2 - 10.1007/s00134-024-07369-9
DO - 10.1007/s00134-024-07369-9
M3 - Journal article
C2 - 38771364
SN - 0342-4642
VL - 50
SP - 813
EP - 831
JO - Intensive Care Medicine
JF - Intensive Care Medicine
IS - 6
ER -