Fluid therapy in critically ill patients: perspectives from the right heart

Page hits: 4223, File downloaded: 879

Download file

Download this file

Open in browser

Open this file in your browser


Paul Elbers, Tim Rodrigus, Esther Nossent, Manu L.N.G. Malbrain, Anton Vonk Noordegraaf


As right heart function can affect outcome in the critically ill patient, a thorough understanding of factors determining right heart performance in health and disease is pivotal for the critical care physician. This review focuses on fluid therapy, which remains controversial in the setting of impending or overt right heart failure. In this context, we will attempt to elucidate which patients are likely to benefit from fluid administration and for which patients fluid therapy would likely be harmful. Following a general discussion of right heart function and failure, we specifically focus on important causes of right heart failure in the critically ill, i.e. sepsis induced myocardial dysfunction, the acute respiratory distress syndrome, acute pulmonary embolism and the effects of positive pressure ventilation. It is argued that fluid therapy should always be cautiously administered with the right heart in mind, which calls for close multimodal monitoring. 

Leave a comment

Please login to leave a comment.

Social Media

  like us on Facebook

  follow us on Twitter

  join Discussion group

  join us on Linkedin

  newsletter sign up

  post on the blog