Fluid management in intensive care medicine. A task with underestimated relevance

In critically ill patients with shock fluid replacement is crucial to stabilize the circulation and organ perfusion. Initially, a hemodynamically controlled, aggressive fluid therapy aims to restore circulation, whereas the second, later phase of therapy is characterized by fluid overload, which then needs to be reverted. Both, an adequate initial shock therapy as well as the subsequent normalization of fluid balance have an important impact on morbidity and mortality and therefore profound proficiencies of fluid management are of need. Here we give a summary of hemodynamic aspects of fluid therapy, the type of fluid replacement and the evaluation of fluid balance in respect to fluid management of the critically ill.