Table 2.

Monitoring of Maintenance IV Fluids.

Monitoring parameter	Specific tests	Considerations	Recommendation for use
Static Hemodynamic Parameters	CVP PCWP EDV	Not recommended for assessing volume responsiveness (i.e., for guiding resuscitation fluids) Good indicators of preload “Normal” values higher in mechanically ventilated patients	Use as safety parameter; decrease/discontinue mIVF if elevated
Dynamic Hemodynamic Parameters28,25,29,30	SVV PPV IVC collapsibility Fluid challenge Passive leg raise	Good indicators of volume responsiveness Use limited to specific populations (e.g., must be mechanically ventilated for SVV) Risk of volume overload with fluid challenge	Use for monitoring resuscitation fluids; do not use for monitoring mIVF
Fluid Balance4,7,10,31–34	Daily fluid balance over 24 hours Cumulative fluid balance over ICU stay	Assumes baseline status was intravascularly replete Excludes interventions made in pre-ICU setting Does not account for fluid shifts Does not account for output from insensible losses Must have accurate and complete charting, including measured urinary voids Should include enteral intake	Recommend to monitor daily and report during interdisciplinary rounds
Weight34–36	Change in weight from baseline	Assumes baseline weight represents intravascularly replete status Must have reliable measurement and charting Limited by gaps in frequency of measurement	Recommend to monitor daily and report during interdisciplinary rounds
“Hidden” Fluid Intake37–10	Volume of IV flushes, blood products, diluents for IV medicationadministration, enteral nutrition	Must have reliable and up-todate charting Must be aware of institutional policies and procedures for IV flushes	Recommend to monitor daily and report during interdisciplinary rounds

Abbreviations: CVP, central venous pressure; PCWP, pulmonary capillary wedge pressure; EDV, end diastolic volume; mIVF, maintenance intravenous fluids; SVV, stroke volume variation; PPV, pulse pressure variation; IVC, inferior vena cava; IV, intravenous.