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British Journal of Anaesthesia 2009 103(2):147-151; doi:10.1093/bja/aep194
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© The Author [2009]. Published by Oxford University Press on behalf of The Board of Directors of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournal.org

Seven misconceptions regarding volume therapy strategies—and their correction

The first 150 words of the full text of this article appear below.

An appropriate intravascular volume replacement is a fundamental component of managing the critically ill surgical or intensive care unit (ICU) patient because the failure to treat hypovolaemia may progress to organ dysfunction or even death.1 Although the importance of adequate volume replacement is widely accepted, there are still no unique accepted recommendations. Aside from different crystalloid solutions, the natural colloid human albumin (HA) and different non-protein (synthetic) colloids have been promoted to treat volume deficits. Over the recent years, some misconceptions or myths of volume replacement concepts have been established that need to be reconsidered and to be corrected when necessary.

First misconception: saline is a physiological solution

Saline solution is an isotonic crystalloid that is still the dominating crystalloid worldwide. It has been termed ‘physiological’ or ‘normal’ saline, but when it is compared with the composition of plasma, one must wonder why it has ever been termed as ‘physiological’. With its high sodium (154 mmol litre–1. . . [Full Text of this Article]

Second misconception: albumin is superior to other plasma substitutes

Third misconception: all colloids are the same

Fourth misconception: crystalloids are as effective as colloids

Fifth misconception: use of pressure-related monitoring variables to guide volume therapy

Sixth misconception: mortality is the only variable that counts for assessing the quality of volume replacement strategies

Seventh misconception: the myth of meta-analyses

Declaration of interest and funding

J. Boldt

Department of Anaesthesiology and Intensive Care Medicine
Klinikum der Stadt Ludwigshafen
D-67063 Ludwigshafen
Germany

E-mail: boldtj@gmx.net


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Volume therapy strategies - misconceptions about misconceptions
Albert Farrugia, et al.
British Journal of Anaesthesia, 12 Aug 2009 [Full text]