Review Article
Volume 4 Issue 6 - 2020
Principles of Intravenous Fluids Therapy
Monira Taha Ismail1,2* and Adel Hamed Elbaih1,2
1Assistant Professor of Emergency Medicine, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
2Associate Professor of Emergency Medicine,Medical Science Department, Sulaiman Al-Rajhi University, Saudi Arabia
*Corresponding Author: Monira Taha Ismail, Assistant Professor of Emergency Medicine, Faculty of Medicine, Suez Canal University, Ismailia, Egypt and Associate Professor of Emergency Medicine, Medical Science Department, Sulaiman Al-Rajhi University, Saudi Arabia.
Received: February 12, 2020; Published: May 08, 2020


Introduction: The hospital ED is one of the most important components of the health care system. There is an increase in numbers of hypovolemic patients visiting EDs leading to overcrowding, long waiting time, missed diagnostic cases and negative impact on patient satisfaction. Hypovolemia is one of the most common reasons people call for emergency medical help. Fortunately, Fluid is about half of healthy adult body weight. Total body fluid in adult male is about 60% of lean body weight, and about 50% of lean body weight in female. Blood is about 11 - 12% of total body fluid. But even if the hypovolemic patients experience has nothing to do, the problem may still be important and worth the time spent in an emergency room for evaluation and intravenous fluids administration So we aimed to update knowledge and review researches in the field of fluids therapy and reduction in waiting time and Overcome Crowdness Patients in emergency department.

Methods: Collection of all possible available data about the intravenous fluids therapy in the Emergency department. By many research questions to achieve these aims so a midline literature search was performed with the keywords “critical care”, “emergency medicine”, “principals of intravenous fluids therapy", "fluids and electrolytes”. All studies introduced that the intravenous fluids therapy is a serious conditions that face patients of the emergency and critical care departments. Literature search included an overview of recent definition, causes and recent therapeutic strategies.

Results: Hypovolemic state can be diagnosed when there are signs and symptoms of hemodynamic compromise and there is apparent source of blood loss. It not easy to diagnose when there is occult blood loss, as internal hemorrhage, into the alimentary tract, or when plasma volume alone is lost. And in all cases should be given fluids therapy for resuscitations firstly.

Conclusion: "Prevention is better than cure" Decline in death rates could be achieved by proper lifesaving interventions by good fluids therapy administrations and then proper approach to determine the causes of hypovolemia in emergency department.

Keywords: Management; Hypovolemia; Fluids Therapy


  1. Laura M Willis. “Fluid and electrolytes made incredibly Easy”. Sixth edition. Wolters Kluwer London (2015).
  2. Abunnaja S., et al. “Enteral and nutrition in the perioperative period: State of the art”. Nutrients 2 (2013): 608-623.
  3. NICE Guideline. Intravenous Fluid Therapy in Adults in Hospital (2013).
  4. Dellinger RP., et al. “Surviving Sepsis Campaign Guidelines Committee Including the Pediatric Subgroup. Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock: 2012”. Critical Care Medicine 2 (2013): 580-637.
  5. Zoja Milovanovic and Abisola Adeleye. “Making sense of fluids and electrolytes”. CRC (2017).
  6. Tinegate H., et al. “Guideline on the investigation and management of acute transfusion reactions. Prepared by the BCSH Blood Transfusion Task Force”. British Journal of Haematology 2 (2012): 143-153.
  7. Yentis SM., et al. “Anaesthesia and Intensive Care A-Z, 5th Edition”. London, UK: Elsevier Churchill Livingstone, 2013.
  8. Kidney Disease. “Improving Global Outcomes (KDIGO) Acute Kidney Injury Work Group. KDIGO Clinical Practice Guideline for Acute Kidney Injury”. Kidney International 2 (2012): 1-138.
  9. Government Safety Alert Regarding HES. “Hydroxyethyl Starch (HES) Products – Increased Risk of Renal Dysfunction and Mortality” (2013).
  10. Kuwahara T., et al. “Effects of lipid emulsion and multivitamins on the growth of microorganisms in peripheral parenteral nutrition solutions”. International Journal of Medical Sciences9 (2013): 1079-1084.
  11. Seres D., et al. “Advantages of enteral nutrition over parenteral nutrition”. Therapeutic Advances in Gastroenterology 6.2 (2013): 157-167.
  12. Altun I. “The efficacy of workshop on body fluids in health and disease and its impact on nurses training”. Pakistan Journal of Medical Sciences2 (2010): 426-429.
  13. Djillali Annane., et al. “Effects of Fluid Resuscitation with Colloids vs Crystalloids on Mortality in Critically Ill Patients Presenting With Hypovolemic Shock The CRISTAL Randomized Trial”. The Journal of the American Medical Association 17 (2013): 1809-1817.
  14. Oliveira RP., et al. “Clinical review: hypertonic saline resuscitation in sepsis”. Critical Care 5 (2002): 418-423.
  15. American Thoracic Society. “Evidence-based colloid use in the critically ill: American Thoracic Society Consensus Statement”. American Journal of Respiratory and Critical Care Medicine 11 (2004): 1247-1259.
  16. Brunkhorst FM., et al. “Competence Network Sepsis (SepNet). Intensive insulin therapy and pentastarch resuscitation in severe sepsis”. The New England Journal of Medicine 2 (2008): 125-139.
  17. Myburgh JA., et al. “CHEST Investigators; Australian and New Zealand Intensive Care Society Clinical Trials Group. Hydroxyethyl starch or saline for fluid resuscitation in intensive care”. The New England Journal of Medicine 20 (2012): 1901-1911.
  18. Perel P., et al. “Colloids versus crystalloids for fluid resuscitation in critically ill patients”. Cochrane Database of Systematic Reviews 2 (2013): CD000567.
  19. Zarychanski R., et al. “Association of hydroxyethyl starch administration with mortality and acute kidney injury in critically ill patients requiring volume resuscitation: a systematic review and meta-analysis”. The Journal of the American Medical Association 7 (2013): 678-688.
  20. Finfer S., et al. “SAFE Study Investigators. A comparison of albumin and saline for fluid resuscitation in the intensive care unit”. The New England Journal of Medicine 22 (2004): 2247-2256.
  21. Delaney AP., et al. “The role of albumin as a resuscitation fluid for patients with sepsis: a systematic review and meta-analysis”. Critical Care Medicine 2 (2011): 386-391.
  22. Marik PE., et al. “Dynamic changes in arterial waveform derived variables and fluid responsiveness in mechanically ventilated patients: a systematic review of the literature”. Critical Care Medicine 37 (2009): 2642-2647.
  23. Cavallaro F., et al. “Diagnostic accuracy of passive leg raising for prediction of fluid responsiveness in adults: systematic review and metaanalysis of clinical studies”. Intensive Care Medicine 36 (2010): 1475-1483.
  24. Vincent JL and Weil MH. “Fluid challenge revisited”. Critical Care Medicine 34 (2006): 1333-1337.
  25. Delaney AP., et al. “The role of albumin as a resuscitation fluid for patients with sepsis: a systematic review and meta-analysis”. Critical Care Medicine 39 (2011): 386-391.
  26. Myburgh JA and Mythen MG. “Resuscitation fluids”. The New England Journal of Medicine 369 (2013): 1243-1251.
  27. Diez BC and Varon AJ. “Airway management and initial resuscitation of the trauma patient”. Current Opinion in Critical Care6 (2009): 542-547.
  28. Cherkas SD and David NM. “Traumatic Hemorrhagic Shock: Advances in Fluid Management”. Emergency Medicine Practice 11 (2011): 9.
  29. Macedo E, Bouchard J and Soroko SH. “Fluid accumulation, recognition and staging of acute kidney injury in critically-ill patients”. Critical Care 14 (2010): R82.
  30. Vaara ST., et al. “Fluidoverload is associated with an increased risk for 90-day mortality in critically ill patients with renal replacementtherapy:data fromthe prospective FINNAKI study”. Critical Care 16 (2012): R197.
  31. Derek N. “Handbook of Transfusion Medicine, 5th Edition”. Norwich, UK: United Kingdom Blood Services (2013).
  32. Patrick D. “Medicine at a Glance, 4th Edition”. Chichester, UK: Wiley-Blackwell (2014).
  33. Peck TE and Hill SA. “Pharmacology for Anaesthesia and Intensive Care, 4th Edition”. Cambridge, UK: Cambridge University Press (2014).
  34. Vincent JL and De Backer D. “Circulatory shock”. The New England Journal of Medicine 369 (2013): 1726-1734.
  35. EA Hoste., et al. “Shaw for the ADQI XII Investigators Group Four phases of intravenous fluid therapy: a conceptual model†”. British Journal of Anaesthesia5 (2014): 740-747.
Citation: Monira Taha Ismail and Adel Hamed Elbaih. “Principles of Intravenous Fluids Therapy”. EC Emergency Medicine and Critical Care 4.6 (2020): 24-46.

PubMed Indexed Article

EC Pharmacology and Toxicology
LC-UV-MS and MS/MS Characterize Glutathione Reactivity with Different Isomers (2,2' and 2,4' vs. 4,4') of Methylene Diphenyl-Diisocyanate.

PMID: 31143884 [PubMed]

PMCID: PMC6536005

EC Pharmacology and Toxicology
Alzheimer's Pathogenesis, Metal-Mediated Redox Stress, and Potential Nanotheranostics.

PMID: 31565701 [PubMed]

PMCID: PMC6764777

EC Neurology
Differences in Rate of Cognitive Decline and Caregiver Burden between Alzheimer's Disease and Vascular Dementia: a Retrospective Study.

PMID: 27747317 [PubMed]

PMCID: PMC5065347

EC Pharmacology and Toxicology
Will Blockchain Technology Transform Healthcare and Biomedical Sciences?

PMID: 31460519 [PubMed]

PMCID: PMC6711478

EC Pharmacology and Toxicology
Is it a Prime Time for AI-powered Virtual Drug Screening?

PMID: 30215059 [PubMed]

PMCID: PMC6133253

EC Psychology and Psychiatry
Analysis of Evidence for the Combination of Pro-dopamine Regulator (KB220PAM) and Naltrexone to Prevent Opioid Use Disorder Relapse.

PMID: 30417173 [PubMed]

PMCID: PMC6226033

EC Anaesthesia
Arrest Under Anesthesia - What was the Culprit? A Case Report.

PMID: 30264037 [PubMed]

PMCID: PMC6155992

EC Orthopaedics
Distraction Implantation. A New Technique in Total Joint Arthroplasty and Direct Skeletal Attachment.

PMID: 30198026 [PubMed]

PMCID: PMC6124505

EC Pulmonology and Respiratory Medicine
Prevalence and factors associated with self-reported chronic obstructive pulmonary disease among adults aged 40-79: the National Health and Nutrition Examination Survey (NHANES) 2007-2012.

PMID: 30294723 [PubMed]

PMCID: PMC6169793

EC Dental Science
Important Dental Fiber-Reinforced Composite Molding Compound Breakthroughs

PMID: 29285526 [PubMed]

PMCID: PMC5743211

EC Microbiology
Prevalence of Intestinal Parasites Among HIV Infected and HIV Uninfected Patients Treated at the 1o De Maio Health Centre in Maputo, Mozambique

PMID: 29911204 [PubMed]

PMCID: PMC5999047

EC Microbiology
Macrophages and the Viral Dissemination Super Highway

PMID: 26949751 [PubMed]

PMCID: PMC4774560

EC Microbiology
The Microbiome, Antibiotics, and Health of the Pediatric Population.

PMID: 27390782 [PubMed]

PMCID: PMC4933318

EC Microbiology
Reactive Oxygen Species in HIV Infection

PMID: 28580453 [PubMed]

PMCID: PMC5450819

EC Microbiology
A Review of the CD4 T Cell Contribution to Lung Infection, Inflammation and Repair with a Focus on Wheeze and Asthma in the Pediatric Population

PMID: 26280024 [PubMed]

PMCID: PMC4533840

EC Neurology
Identifying Key Symptoms Differentiating Myalgic Encephalomyelitis and Chronic Fatigue Syndrome from Multiple Sclerosis

PMID: 28066845 [PubMed]

PMCID: PMC5214344

EC Pharmacology and Toxicology
Paradigm Shift is the Normal State of Pharmacology

PMID: 28936490 [PubMed]

PMCID: PMC5604476

EC Neurology
Examining those Meeting IOM Criteria Versus IOM Plus Fibromyalgia

PMID: 28713879 [PubMed]

PMCID: PMC5510658

EC Neurology
Unilateral Frontosphenoid Craniosynostosis: Case Report and a Review of the Literature

PMID: 28133641 [PubMed]

PMCID: PMC5267489

EC Ophthalmology
OCT-Angiography for Non-Invasive Monitoring of Neuronal and Vascular Structure in Mouse Retina: Implication for Characterization of Retinal Neurovascular Coupling

PMID: 29333536 [PubMed]

PMCID: PMC5766278

EC Neurology
Longer Duration of Downslope Treadmill Walking Induces Depression of H-Reflexes Measured during Standing and Walking.

PMID: 31032493 [PubMed]

PMCID: PMC6483108

EC Microbiology
Onchocerciasis in Mozambique: An Unknown Condition for Health Professionals.

PMID: 30957099 [PubMed]

PMCID: PMC6448571

EC Nutrition
Food Insecurity among Households with and without Podoconiosis in East and West Gojjam, Ethiopia.

PMID: 30101228 [PubMed]

PMCID: PMC6086333

EC Ophthalmology
REVIEW. +2 to +3 D. Reading Glasses to Prevent Myopia.

PMID: 31080964 [PubMed]

PMCID: PMC6508883

EC Gynaecology
Biomechanical Mapping of the Female Pelvic Floor: Uterine Prolapse Versus Normal Conditions.

PMID: 31093608 [PubMed]

PMCID: PMC6513001

EC Dental Science
Fiber-Reinforced Composites: A Breakthrough in Practical Clinical Applications with Advanced Wear Resistance for Dental Materials.

PMID: 31552397 [PubMed]

PMCID: PMC6758937

EC Microbiology
Neurocysticercosis in Child Bearing Women: An Overlooked Condition in Mozambique and a Potentially Missed Diagnosis in Women Presenting with Eclampsia.

PMID: 31681909 [PubMed]

PMCID: PMC6824723

EC Microbiology
Molecular Detection of Leptospira spp. in Rodents Trapped in the Mozambique Island City, Nampula Province, Mozambique.

PMID: 31681910 [PubMed]

PMCID: PMC6824726

EC Neurology
Endoplasmic Reticulum-Mitochondrial Cross-Talk in Neurodegenerative and Eye Diseases.

PMID: 31528859 [PubMed]

PMCID: PMC6746603

EC Psychology and Psychiatry
Can Chronic Consumption of Caffeine by Increasing D2/D3 Receptors Offer Benefit to Carriers of the DRD2 A1 Allele in Cocaine Abuse?

PMID: 31276119 [PubMed]

PMCID: PMC6604646

EC Anaesthesia
Real Time Locating Systems and sustainability of Perioperative Efficiency of Anesthesiologists.

PMID: 31406965 [PubMed]

PMCID: PMC6690616

EC Pharmacology and Toxicology
A Pilot STEM Curriculum Designed to Teach High School Students Concepts in Biochemical Engineering and Pharmacology.

PMID: 31517314 [PubMed]

PMCID: PMC6741290

EC Pharmacology and Toxicology
Toxic Mechanisms Underlying Motor Activity Changes Induced by a Mixture of Lead, Arsenic and Manganese.

PMID: 31633124 [PubMed]

PMCID: PMC6800226

EC Neurology
Research Volunteers' Attitudes Toward Chronic Fatigue Syndrome and Myalgic Encephalomyelitis.

PMID: 29662969 [PubMed]

PMCID: PMC5898812

EC Pharmacology and Toxicology
Hyperbaric Oxygen Therapy for Alzheimer's Disease.

PMID: 30215058 [PubMed]

PMCID: PMC6133268

News and Events

November Issue Release

We always feel pleasure to share our updates with you all. Here, notifying you that we have successfully released the November issue of respective journals and the latest articles can be viewed on the current issue pages.

Submission Deadline for Upcoming Issue

ECronicon delightfully welcomes all the authors around the globe for effective collaboration with an article submission for the upcoming issue of respective journals. Submissions are accepted on/before December 15, 2022.

Certificate of Publication

ECronicon honors with a "Publication Certificate" to the corresponding author by including the names of co-authors as a token of appreciation for publishing the work with our respective journals.

Best Article of the Issue

Editors of respective journals will always be very much interested in electing one Best Article after each issue release. The authors of the selected article will be honored with a "Best Article of the Issue" certificate.

Certifying for Review

ECronicon certifies the Editors for their first review done towards the assigned article of the respective journals.

Latest Articles

The latest articles will be updated immediately on the articles in press page of the respective journals.