SCCM Resource Library-Optimizing Fluid Stewardship in Your ICU

Video Transcription

Video Summary

This video transcript discusses the concept of de-resuscitation and fluid stewardship in the ICU. The speaker explains that while fluid resuscitation is important in the early stages of shock, continued aggressive fluid administration can lead to positive fluid balance and potential harm to the patient. The speaker proposes different phases of fluid management, including resuscitation, optimization, stabilization, and evacuation, each with different goals and approaches to fluid administration. The speaker emphasizes the need for careful monitoring of fluid balance and the use of dynamic measures to guide fluid therapy, such as mean arterial pressure, cardiac indices, and volumetric measures. They also discuss the importance of de-resuscitation, in which fluid intake is reduced and diuretics may be used to achieve a negative fluid balance. The speaker suggests that implementing protocols for de-resuscitation may be helpful in guiding clinical practice and ensuring optimal fluid management.

Asset Subtitle

Pharmacology, Quality and Patient Safety, 2020

Asset Caption

The Society of Critical Care Medicine's Critical Care Congress features internationally renowned faculty and content sessions highlighting the most up-to-date, evidence-based developments in critical care medicine. This is a presentation from the 2020 Critical Care Congress held February 16-19, 2020, in Orlando, Florida, USA.

Learning Objectives

Examine the role of fluid stewardship in critically ill patients
Assess end points of de-resuscitation in the ICU
Examine the role of central venous pressure in starting, monitoring, and ending de-resuscitation as part of fluid stewardship in the ICU
Apply fluid stewardship in special populations, especially obstetrics, neonates, and comorbidities such as diabetic ketoacidosis, burns, and dengue hemorrhagic fever

What Is Fluid Stewardship and How Should It Be Applied in the ICU?

Michael A. Pisa

Diuretics and Managing Fluids

Tyree H. Kiser

Assessing End Points of De-Resuscitation in the ICU

Timothy Ellender

Meta Tag

Content Type Presentation

Knowledge Area Pharmacology

Knowledge Area Quality and Patient Safety

Knowledge Level Foundational

Membership Level Select

Membership Level Professional

Membership Level Associate

Tag Mortality

Tag Fluids Resuscitation Management

Year 2020

Keywords

de-resuscitation

fluid stewardship

ICU

fluid resuscitation

shock

positive fluid balance

fluid management

mean arterial pressure

cardiac indices

de-resuscitation protocols

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