AAHA AAHA Guidelines Changes in fluid distribution

Changes in fluid distribution

Examples of common disorders causing changes in fluid distribution

  • Any disease causing pulmonary or peripheral edema
  • Any disease causing pleural or abdominal effusion
Fluid distribution abnormalities include edema (pulmonary, peripheral, interstitial) and effusions (pleural, abdominal, through the skin of burn patients). Two main causes of edema/effusion are loss of intravascular oncotic pressure and loss of vascular integrity. Consider concurrent dehydration and whole patient volume deficits when treating patients with abnormal fluid distribution.

 

Suggested specific approaches to fluid therapy include the following:

  • Pulmonary edema/volume overload: stop fluid administration, consider diuretics, address cardiovascular disease if present, and provide mechanical ventilation with positive end-expiratory pressure (if indicated).
  • Pleural/abdominal effusions: stop fluid administration, administer diuretics if indicated, address cause(s) of effusion, perform either abdomino- or thoracocentesis if respiration is compromised.