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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)
| 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 | ↑ | (−) | (+) | |
