Fluid Management in COVID-19

Upon initial presentation, most COVID-19 patients are in a stable haemodynamic state and typically do not require intravenous (IV) fluid resuscitation. The virus primarily affects the lungs, thus the initial focus is on providing oxygen and respiratory support to the patient. Although there is limited direct research on IV fluid management for COVID-19 patients, data from observational studies suggest that patients with COVID-19-related acute respiratory distress syndrome (ARDS) exhibit higher levels of extravascular lung water and require longer periods of mechanical ventilation the more positive the cumulative fluid balance. As a result, this chapter draws on evidence from studies on fluid management for non-COVID-19 ARDS patients and pathophysiology research on COVID-19 ARDS.