Advances in resuscitation and deresuscitation
Traditional fluid resuscitation strategies that relied on liberal plasma volume expansion, have evolved into more refined, patient-centered approaches that align fluid administration with preload responsiveness. This shift has been driven by advances in hemodynamic monitoring, the development of personalized fluid titration protocols, and an enhanced understanding of injuryand sepsis pathophysiologic responses, that support shift towards precision medicine. The ROSE concept (Resuscitation, Optimization, Stabilization and Evacuation) clearly depicts the phases of fluid therapy for a patient with critical illness or injury. This review summarizes recent fluid management advances that support precise titration of plasma volume expansion to avoid excess total body salt and water, minimize organ injury, and enable more rapid and effective deresuscitation.
Patients should only undergo plasma volume expansion when they demonstrate the potential for preload responsive cardiac performance
