ABSTRACT
Fluid therapy is one of the most important components of supportive care administered in the intensive care unit (ICU). The difference between a routine hospital course and one complicated by organ failure is often determined by decisions related to fluid management. Patients with primarily medical disorders often have the disadvantage of harboring infections or other disease processes for days or more, prior to receiving aggressive therapy in an ICU. Surgical patients often are ambulatory prior to their operations; therefore, while the operations themselves may be sources of considerable stress, an opportunity exists to optimize the patient’s physiology closer to the time of injury, and create a better outcome. This chapter will address issues related to fluid therapy in the critically ill, with an emphasis on patients after major surgery. Physiology related to fluid distribution will first be reviewed, and choices of fluid and preoperative and postoperative resuscitation strategies will then be discussed.
