Table 2 Guidelines on fluid management and resuscitation

Surviving Sepsis Campaign: international guidelines for management of sepsis and septic shock: 2016

Rhodes A. et al. 2017 [2]

We recommend that a fluid challenge technique be applied where fluid administration is continued as long as hemodynamic factors continue to improve

Best practice statement

We recommend crystalloids as the fluid of choice for initial resuscitation and subsequent intravascular volume replacement in patients with sepsis and septic shock

1B

We suggest using either balanced crystalloids or saline for fluid resuscitation of patients with sepsis or septic shock

2C

We suggest using albumin in addition to crystalloids for initial resuscitation and subsequent intravascular volume replacement in patients with sepsis and septic shock when patients require substantial amounts of crystalloids.

2C

We recommend against using hydroxyethyl starches (HESs) for intravascular volume replacement in patients with sepsis or septic shock

1A

We suggest using crystalloids over gelatins when resuscitating patients with sepsis or septic shock

2C

The clinical practice guideline for the management of ARDS in Japan

Hashimoto et al. 2017 [64]

We suggest fluid restriction in the management of adult patients with ARDS.

2B

Weak recommendation

Moderate quality evidence

Scandinavian clinical practice guidelines in fluid and drug therapy in adults with acure respiratory distress syndrome

Claesson et al. 2016 [65]

We suggest fluid restriction over a liberal fluid strategy in adults with ARDS

Weak recommendation

Moderate quality evidence

European guideline on management of major bleeding and coagulopathy following trauma

Rossaint et al., 2016 [88]

We recommend that fluid therapy using isotonic crystalloid solutions be initiated in the hypotensive bleeding trauma patient

1A

We suggest that excessive use of 0.9% NaCl solution be avoided

2C

We recommend that hypotonic solutions such as Ringer’s lactate be avoided in patients with severe head trauma

1C

We suggest the use of colloids be restricted due to the adverse effects on haemostasis

2C

AKI in the perioperative period & in ICU: french expert recommendations

Ichai C et al.

2016 [111]

We recommend not administering hydroxyethylstarch (HES) in the ICU.

STRONG agreement

1B

We suggest the preferential use of crystralloid instead of colloid for fluid loading.

STRONG agreement

2A

We suggest preferring balanced solutions in case of large volume loading.

STRONG agreement

2A

After hemodynamic stabilisation, we suggest avoiding fluid overload in the ICU.

STRONG agreement

2A