Day 2

Crystalloids and colloids used in critically ill patients have different fluid composition. The composition may affect many things, including response to administration, clinical outcomes, and adverse effects. This talk with discuss the evidence behind the different types of fluids in critically ill patients, including a discussion of pros and cons of each fluid type. The session will be an interactive discussion led by investigators who have conducted randomized trials of different types of intravenous fluids.

Resuscitation fluids save lives in humans with life-threatening hypovolaemia. The fluid of choice should have biochemical characteristics close to the type of fluid lost and replaced at a rate and volume sufficient to correct severe fluid deficit. Then stop and consider the early use of catecholamines. There are few indications to give critically ill patients resuscitation fluids after 24 hours of admission. There is no place for synthetic colloids of non-physiological crystalloids. The effects of unnecessary fluids last well beyond the initial resuscitation period and are associated with adverse effects and harm to the patient. Fluids are toxic drugs and must be used with great care.

John Myburgh

John Myburgh is a South African-born, Australian Intensive Care clinician- researcher. He has worked at the coal face in the ICU for the last 35 years, and led national and international research programs over the last 25 years directed at answering fundamental clinical questions to improve the lives of critically ill patients and their families. An avid teacher and mentor, he has based his style on his mentors who always stressed that the patient comes first, that teaching others was both a privilege and a duty and to question everything, particularly fundamentalism and dogma. A a SMACC Frequent Flyer, John is a dedicated rower on Middle Harbour in Sydney, the proud owner of 4 guitars (including a Fender Strat and Tele) and devoted Dad.

 

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