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Fluid Resuscitation and Immunomodulation in the Critically III

  • Conference paper
Yearbook of Intensive Care and Emergency Medicine

Part of the book series: Yearbook of Intensive Care and Emergency Medicine ((YEARBOOK,volume 2006))

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Conclusion

Fluid resuscitation induces immunomodulation in the critically ill. Current evidence is robust enough to suggest that interventions that induce/prolong inflammatory responses are associated with adverse outcomes in critically ill patients. Therefore, an ‘ideal’ resuscitation fluid in addition to being an effective volume expander should minimize iatrogenic metabolic acidosis and pro-inflammatory mediator expression. While normal saline and perhaps even lactated Ringer’s solution appear to be associated with pro-inflammatory effects, fluids such as hypertonic saline may be associated with anti-inflammatory effects. Solutions such as Hextend may be less likely to be immunomodulating. Further large human studies are required to characterize these effects and their impact on outcomes in the critical care setting.

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Author information

Authors and Affiliations

  1. Critical Care Medicine, University of Pittsburgh, 3550 Terrace Street, Pittsburgh, PA, 15261, USA

    M. Raghavan

  2. Department of Critical Care Medicine, University of Pittsburgh, 3550 Terrace Street, Pittsburgh, PA, 15261, USA

    H. Murray & J. A. Kellum

Authors
  1. M. Raghavan
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  2. H. Murray
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  3. J. A. Kellum
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Editor information

Editors and Affiliations

  1. Department of Intensive Care, Erasme Hospital, Free University of Brussels, Route de Lennik 808, B-1070, Brussels, Belgium

    Jean-Louis Vincent (Head) (Head)

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© 2006 Springer-Verlag Berlin Heidelberg

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Raghavan, M., Murray, H., Kellum, J.A. (2006). Fluid Resuscitation and Immunomodulation in the Critically III. In: Vincent, JL. (eds) Yearbook of Intensive Care and Emergency Medicine. Yearbook of Intensive Care and Emergency Medicine, vol 2006. Springer, Berlin, Heidelberg. https://doi.org/10.1007/3-540-33396-7_7

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  • DOI: https://doi.org/10.1007/3-540-33396-7_7

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-30155-4

  • Online ISBN: 978-3-540-33396-8

  • eBook Packages: MedicineMedicine (R0)

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