open access

Vol 47 (2015): Special issue
Review articles
Published online: 2015-11-18
Submitted: 2015-10-23
Accepted: 2015-11-17
Get Citation

Fluid therapy in critically ill patients: perspectives from the right heart

Paul Elbers, Tim Rodrigus, Esther Nossent, Manu L.N.G. Malbrain, Anton Vonk-Noordegraaf
DOI: 10.5603/AIT.a2015.0080

open access

Vol 47 (2015): Special issue
Review articles
Published online: 2015-11-18
Submitted: 2015-10-23
Accepted: 2015-11-17

Abstract

As right heart function can affect outcome in the critically ill patient, a thorough understanding of factors determining right heart performance in health and disease is pivotal for the critical care physician. This review focuses on fluid therapy, which remains controversial in the setting of impending or overt right heart failure. In this context, we will attempt to elucidate which patients are likely to benefit from fluid administration and for which patients fluid therapy would likely be harmful. Following a general discussion of right heart function and failure, we specifically focus on important causes of right heart failure in the critically ill, i.e. sepsis induced myocardial dysfunction, the acute respiratory distress syndrome, acute pulmonary embolism and the effects of positive pressure ventilation. It is argued that fluid therapy should always be cautiously administered with the right heart in mind, which calls for close multimodal monitoring.

Abstract

As right heart function can affect outcome in the critically ill patient, a thorough understanding of factors determining right heart performance in health and disease is pivotal for the critical care physician. This review focuses on fluid therapy, which remains controversial in the setting of impending or overt right heart failure. In this context, we will attempt to elucidate which patients are likely to benefit from fluid administration and for which patients fluid therapy would likely be harmful. Following a general discussion of right heart function and failure, we specifically focus on important causes of right heart failure in the critically ill, i.e. sepsis induced myocardial dysfunction, the acute respiratory distress syndrome, acute pulmonary embolism and the effects of positive pressure ventilation. It is argued that fluid therapy should always be cautiously administered with the right heart in mind, which calls for close multimodal monitoring.

Get Citation

Keywords

intensive care; fluid therapy, right heart failure

About this article
Title

Fluid therapy in critically ill patients: perspectives from the right heart

Journal

Anaesthesiology Intensive Therapy

Issue

Vol 47 (2015): Special issue

Pages

38-43

Published online

2015-11-18

DOI

10.5603/AIT.a2015.0080

Keywords

intensive care
fluid therapy
right heart failure

Authors

Paul Elbers
Tim Rodrigus
Esther Nossent
Manu L.N.G. Malbrain
Anton Vonk-Noordegraaf

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