From the Physiology to the Bedside: Fluid Therapy in Cardiac Surgery and the ICU

Purpose of Review In this review, we summarize the evidence present in the literature about this important field, with particular attention to the peculiarities of cardiac surgery. Recent Findings Since water is the main component of human cells and tissue, together with electrolytes and proteins, the manipulation of this element in critical illness is a powerful tool in the hands of the anesthesiologist and intensive care doctor. It can be either extraordinarily effective in the treatment of the patient’s disease and in correcting the hemodynamic instability or it can lead to very dangerous consequences, such as edema or end-organ damage. The potential consequences of this therapy require a proper monitoring system and the possibility to correctly assess the probability of the patient to respond to a fluid bolus in the macro- and microhemodynamics. Summary Fluid therapy has potentially enormous advantages when the indication is correctly given and balanced to the potential side effects.