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IV Fluid Maintenance Strategy
- Prefer to avoid maintenance IV fluids routinely; use bolus fluids for volume indications.
- Choose Lactated Ringer's for maintenance if needed, except in neuro ICU where normal saline is preferred.
Rethinking Maintenance Fluids
- Maintenance fluid needs are often overestimated since patients receive fluids from other sources.
- Unlike the ICU, humans do not receive continuous fluid infusions between meals in normal life.
Diuresis with Loop Diuretics
- Use IV furosemide for diuresis starting with bolus doses, then schedule if ongoing needed.
- Consider switching to bumetanide if initial therapy is inadequate, but usually stick with furosemide.