Fluid replacement

Oral rehydration therapy (ORT) is a simple treatment for dehydration associated with diarrhea, particularly gastroenteritis/gastroenteropathy, such as that caused by cholera or rotavirus.

For most mild to moderate dehydration in children, the preferable treatment in an emergency department is ORT over intravenous replacement of fluid.

[citation needed] The table to the right shows daily requirements for some major fluid components.

[citation needed] Resuscitation fluid can be broadly classified into: albumin solution, semisynthetic colloids, and crystalloids.

A systematic review found no evidence that resuscitation with colloids, instead of crystalloids, reduces the risk of death in patients with trauma or burns, or following surgery.

[6] The amount of maintenance IV fluid required in 24 hours is based on the weight of the patient using the Holliday-Segar formula.

[9] It is important to achieve a fluid status that is good enough to avoid low urine production.

The Parkland formula is not perfect and fluid therapy will need to be titrated to hemodynamic values and urine output.

For example, the planning of fluid replacement for burn patients is based on the Parkland formula (4mL Lactated Ringers X weight in kg X % total body surface area burned = Amount of fluid ( in ml) to give over 24 hours).

[13] 4% human albumin may be used in cirrhotic patients with spontaneous bacterial peritonitis as it can reduce the rate of kidney failure and improve survival.

The 2012 KDIGO (Kidney Disease: Improving Global Outcomes) guidelines stated that diuretics should not be used to treat AKI, except for the management of volume overload.

The use of mechanical ventilation in such case can cause barotrauma, infection, and oxygen toxicity, leading to acute respiratory distress syndrome.

[11] Fluid overload also stretches the arterial endothelium, which causes damage to the glycocalyx, leading to capillary leakage and worsens the acute kidney injury.