Liberal Versus Conservative Fluid Therapy in COVID-19 Patients: What is the Best Strategy for the Treatment of Critically ill Patients?

Abstract

fluid exudation causing pulmonary edema; this, in turn, leads to alveolar gas exchange disorders.[13] In this way, due to pulmonary edema in critical COVID‐19 patients, excessive fluid therapy and a positive fluid balance in COVID‐19 patients too could increase extravascular lung water due to pulmonary capillary leak and this affecting gas exchange, resulting in a worse prognosis;[14] therefore, according to this and in view of the benefit observed in other ARDS or sepsis populations, the consequences of a positive fluid balance, the possible reduction in the cost of administering less fluids, and the feasibility of the intervention, it has been suggested to use a conservative strategy over a liberal fluid therapy in critical patients with COVID‐19. This conservative approach could reduce the occurrence of a positive fluid balance while ensuring tissue perfusion.[7,9,14]