Decompensated Cirrhosis and Fluid Resuscitation

Abstract

The critically ill patient with decompensated cirrhosis has a unique physiology and alterations in albumin that need to be understood to properly resuscitate them and minimize morbidity and mortality. Little data exist on specific resuscitation of the patient with cirrhosis compared with those patients without liver disease. The effectiveness of albumin administration compared with saline administration in common settings, such as large-volume paracentesis, can be extrapolated to the care of the general surgical patient but further studies in this area are warranted. This article enhances the understanding of unique physiology of the patient with decompensated cirrhosis to guide their needs in fluid resuscitation in critical illness.

Keywords: Albumin; Antidiuretic hormone; Cirrhosis; Hepatorenal syndrome; Hyponatremia; Normal saline.