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Table 1 Suggested fluid therapy to treat hypotension in critical illness on the theoretical basis of capillary hydrostatic pressure (P C)

From: Context-sensitive fluid therapy in critical illness

Context P C Fluid volume loading Vasopressor Comments
Anesthesia (−) (+)  
  (+) (+) Low MAP can decrease P C despite vasodilation.
Surgery
 Hemorrhage (+) Use only when MAP is too low to preserve tissue perfusion.  
 Long-duration Restrict crystalloid infusion (e.g., 3 ml kg−1 h−1). If hypovolemia is suspected, repeat crystalloid or colloid bolus (e.g., 4 ml kg−1 over 10–15 min). Use if vasodilation due to inflammation is suspected.  
Trauma
 Uncontrolled bleeding (+) Use only when MAP is too low to preserve tissue perfusion. Avoid full restoration of MAP (≥60 mmHg) because of a risk of bleeding.
Sepsis
 Early (+) Use only when MAP is too low to preserve tissue perfusion.  
 After fluid volume loading (−) (+)  
  1. (+) recommended, (−) not recommended, MAP mean arterial pressure