SensitIV

Intravenous (IV) fluids are a therapy used ubiquitously in critically ill patients; they are the mainstay of treatment in patients who are in shock (low blood pressure resulting in end-organ damage) from severe infection or traumatic hemorrhage until the underlying cause can be found and treated. However, it is difficult to judge the appropriate amount of IV fluids to administer. Too little, and the patient remains in shock, at risk of stroke, heart attack, and death. Too much, and the patient is at risk of fluid flooding their organs, increasing length of ICU stay, length of ventilator dependence, need for dialysis, and risk of postoperative infections. Further, patients who suffer a large insult also sustain damage to the lining of their capillaries, resulting in highly permeable, “leaky” blood vessels. This last variable, capillary permeability, is currently an unknown, without which we are walking a tightrope blindfolded. Bedside knowledge of capillary permeability, and thus the efficacy of IV fluid administration, would enable clinicians to successfully get a patient out of life-threatening shock while avoiding the life-threatening complications of over treatment.