Critical Matters Rational Fluid Therapy
Jan 9, 2025
Adrian Wong, a consultant and clinical lead at King’s College Hospital in London, explores rational fluid therapy's complexities in critical care. He emphasizes evidence-based practices for better patient outcomes. Wong discusses the 'four Ds' framework and the significance of fluid stewardship. He addresses recent IV fluid shortages and the implications for hospitals. The conversation also highlights the 'ROSE' framework for managing critically ill patients and examines ethical considerations in treatment choices, urging a focus on quality of life.
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Fluids in Intensive Care
- Consider fluid management as core intensive care practice.
- Recognize the variability in fluid administration approaches.
Fluids as Medications
- Think of fluids as medications with indications and contraindications.
- Utilize the "4 Ds" framework: drug, dosing, duration, and de-escalation.
Applying the 4 Ds
- Diagnose the underlying issue before administering fluids.
- Consider fluid type, dose, duration, and de-escalation strategy.
