In critically ill patients, adequate cardiac output and oxygen delivery must be provided to sustain life. This is not a simple task because plasma exchanges with the extracellular fluid and is influenced by events occurring at the capillary wall and within the endothelial cells. In addition, damage to epithelial cells causes loss of plasma volume into potential spaces. As different pathological conditions develop, such as in the inflammatory response associated with ischemia and reperfusion and in sepsis, various other systems are activated, and maintenance of proper fluid balance becomes difficult to achieve ( AuklandandReed 1993).
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