Skip to main content

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