Critical Care Time 25. Diuresis & Negative Fluid Balance
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Jun 3, 2024 Explore the challenges of fluid management in critical care, including mindful fluid administration, optimal medication delivery, and diuretic nephrotoxicity. Dive into the nuances of loop diuretics, choosing between purosamide and pumetinide, and optimizing drug delivery with hyper-oncotic albumin. Learn about the importance of continuous patient monitoring and engagement in critical care, with insights on alternative therapies like CRRT and oral formulations for effective patient care.
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Fluid Management
- Prevent organ edema by avoiding excessive fluid administration.
- Use fluids thoughtfully, not reflexively, and consider the patient's ability to drink.
Fluid Resuscitation
- Use fluid boluses judiciously during resuscitation.
- Consider passive leg raises to assess fluid responsiveness before giving a bolus.
Maintenance Fluids
- Avoid maintenance fluids in patients who can drink or are temporarily NPO.
- Prioritize enteral feeding for hydration and nutrition whenever possible.