Table 2.

Putative mechanisms by which fluid overload leads to worse outcomes

Putative mechanisms by which fluid overload leads to worse outcomes
Organ edema leading to impaired organ function
Distortion of tissue architecture
Impairment of oxygen and metabolite diffusion
Obstruction of capillary flow and lymphatic drainage
Initiation or exacerbation of intra-abdominal hypertension and the abdominal compartment syndrome
Compression of intra-abdominal vessels
Compromised microvascular blood flow
Increased renal venous pressure, leading to oliguria and decreased glomerular filtration rate
Masking the presence, delaying the recognition, or underestimating severity of AKI
Increased risk of sepsis
Increased gut edema with impaired barrier function and bacterial translocation
Generalized immunocompromised state associated with AKI
Cytokine release, insulin resistance, oxidative stress