Resources
Also at your disposal are a number of useful links, which will take you to guidelines on fluid management along with other relevant sites.
In This Section
European Association for the Study of the Liver (EASL) clinical practice guidelines on the management of decompensated cirrhosis, including ascites, spontaneous bacterial peritonitis (SBP), and hepatorenal syndrome in cirrhosis are available (European Association for the Study of the Liver, 2018).
The progression from compensated to decompensated cirrhosis is marked by numerous overt clinical signs such as ascites, bleeding, encephalopathy, and jaundice. The progression of the disease and the associated complications can reduce median survival from 12 years to approximately 2 years. The need for effective management of these symptoms has led the European Association for the Study of the Liver to publish their first Clinical Practice Guidelines for the management of decompensated cirrhosis. The recommendation of albumin infusion is seen across the guidelines for a number of the complications discussed. This infographic highlights the role of albumin has in managing the signs and symptoms of decompensated cirrhosis.
An asymptomatic compensated phase followed by a decompensated phase characterises the natural history of cirrhosis. It is also marked by the development of overt clinical signs. The most frequent of which are ascites, bleeding, encephalopathy, and jaundice. See the Clinical Practice Guideline.
Useful Links
This section of the Fluid Management Learning Zone provides links to external sites, where you will be able to further your knowledge of fluid management to provide your patients with the most appropriate treatment option.
Management of Decompensated Cirrhosis EASL Guideline
An asymptomatic compensated phase followed by a decompensated phase characterises the natural history of cirrhosis. It is also marked by the development of overt clinical signs. The most frequent of which are ascites, bleeding, encephalopathy, and jaundice. See the Clinical Practice Guideline.
Association of hydroxyethyl starch administration - jama.jamanetwork.com
Follow this link to the 2013 article 'Association of hydroxyethyl starch administration with mortality and acute kidney injury in critically ill patients requiring volume resuscitation: A systematic review and meta-analysis', by Zarychanski et al.
Albumin for end-stage liver disease
This article, 'Albumin for end-stage liver disease', was published in the Korean Journal of Internal Medicine in 2012.
Guidelines in adult surgical patients
The British Association for Parenteral and Enteral Nutrition (BAPEN) hosts the British Consensus Guidelines on Intravenous Fluid Therapy for Adult Surgical Patients (GIFTASUP), last revised in 2011.
How to select optimal maintenance intravenous fluid therapy
Read the full text of the article 'How to select optimal maintenance intravenous fluid therapy', published in QJM in 2003, by Shafiee et al.
NICE guideline: Intravenous fluid therapy in adults in hospital
The relevant guidance from the UK's National Institute for Health and Care Excellence (NICE), published in December 2013, can be accessed directly through this link.
Paediatric guidelines – Australia
The Royal Children's Hospital, Melbourne, has compiled these clinical practice guidelines for the use of IV fluids in children.
Paediatric guidelines – New Zealand
A section on the use of IV fluids in children, compiled by clinicians at Starship Children's Health hospital in Auckland, can be found here.
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