{"doi":"10.1002/phar.2763","title":"Precision fluid and vasoactive drug therapy for critically ill patients","abstract":"<jats:title>Abstract</jats:title><jats:p>There are several clinical practice guidelines concerning the use of fluid and vasoactive drug therapies in critically ill adult patients, but the recommendations in these guidelines are often based on low‐quality evidence. Further, some were compiled prior to the publication of landmark clinical trials, particularly in the comparison of balanced crystalloid and normal saline. An important consideration in the treatment of critically ill patients is the application of precision medicine to provide the most effective care to groups of patients most likely to benefit from the therapy. Although not currently widely integrated into these practice guidelines, the utility of precision medicine in critical illness is a recognized research priority for fluid and vasoactive therapy management. The purpose of this narrative review was to illustrate the evaluation and challenges of providing precision fluid and vasoactive therapies to adult critically ill patients. The review includes a discussion of important investigations published after the release of currently available clinical practice guidelines to provide insight into how recommendations and research priorities may change future guidelines and bedside care for critically ill patients.</jats:p>","journal":"Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy","year":2023,"id":644289,"datarank":0.48383758840937996,"base_score":2.4849066497880004,"endowment":2.4849066497880004,"self_citation_contribution":0.37273599746820013,"citation_network_contribution":0.11110159094117981,"self_endowment_contribution":0.37273599746820013,"citer_contribution":0.11110159094117981,"corpus_percentile":null,"corpus_rank":null,"citation_count":11,"citer_count":6,"citers_with_citation_signal":3,"citers_with_endowment":3,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1676878,"name":"Rochelle M. Gellatly","orcid":null,"position":1,"is_corresponding":false},{"id":531801,"name":"Brian L. Erstad","orcid":"0000-0001-8909-9921","position":2,"is_corresponding":false},{"id":383294,"name":"Seth R. Bauer","orcid":"0000-0002-0420-0320","position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"Precision fluid and vasoactive drug therapy for critically ill patients","abstract":"<jats:title>Abstract</jats:title><jats:p>There are several clinical practice guidelines concerning the use of fluid and vasoactive drug therapies in critically ill adult patients, but the recommendations in these guidelines are often based on low‐quality evidence. Further, some were compiled prior to the publication of landmark clinical trials, particularly in the comparison of balanced crystalloid and normal saline. An important consideration in the treatment of critically ill patients is the application of precision medicine to provide the most effective care to groups of patients most likely to benefit from the therapy. Although not currently widely integrated into these practice guidelines, the utility of precision medicine in critical illness is a recognized research priority for fluid and vasoactive therapy management. The purpose of this narrative review was to illustrate the evaluation and challenges of providing precision fluid and vasoactive therapies to adult critically ill patients. The review includes a discussion of important investigations published after the release of currently available clinical practice guidelines to provide insight into how recommendations and research priorities may change future guidelines and bedside care for critically ill patients.</jats:p>","is_dataset_classified":null,"base_score":2.4849066497880004,"endowment":2.4849066497880004,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"36606689","pmcid":"PMC10323046","openalex_id":"https://openalex.org/W4313649346","authors":[],"funders":[{"funder_name":"National Institute of General Medical Sciences","grant_id":"K08GM147806","title":null}],"total_grants":1,"fwci":1.959,"citation_percentile":0.85454994,"influential_citations":0,"citation_trend":[{"year":2023,"count":4},{"year":2024,"count":4},{"year":2025,"count":2},{"year":2026,"count":1}],"oa_status":"bronze","license":"http://onlinelibrary.wiley.com/termsAndConditions#vor","oa_locations":[{"url":"https://onlinelibrary.wiley.com/doi/pdfdirect/10.1002/phar.2763","host_type":"journal"},{"url":"https://onlinelibrary.wiley.com/doi/pdfdirect/10.1002/phar.2763","host_type":"publisher"},{"url":"https://onlinelibrary.wiley.com/doi/pdf/10.1002/phar.2763","host_type":"publisher"},{"url":"https://onlinelibrary.wiley.com/doi/full-xml/10.1002/phar.2763","host_type":"publisher"},{"url":"https://accpjournals.onlinelibrary.wiley.com/doi/pdf/10.1002/phar.2763","host_type":"publisher"},{"url":"https://doi.org/10.1002/phar.2763","host_type":"journal"},{"url":"https://pubmed.ncbi.nlm.nih.gov/36606689","host_type":"repository"},{"url":"https://www.ncbi.nlm.nih.gov/pmc/articles/10323046","host_type":"repository"},{"url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC10323046/pdf/nihms-1896433.pdf","host_type":"repository"}],"fields_of_study":["Trauma, Hemostasis, Coagulopathy, Resuscitation","Sepsis Diagnosis and Treatment","Electrolyte and hormonal disorders"],"mesh_terms":["Crystalloid Solutions","Adult","Fluid Therapy","Humans","Critical Illness"],"keywords":["Medicine","Intensive care medicine","Vasoactive","Critically ill","Precision medicine","Clinical trial","MEDLINE","Critical illness","Clinical Practice","Medical laboratory","Evidence-based medicine","Alternative medicine","Physical therapy","Internal medicine","Nursing","Pathology","Albumin","Fluid Therapy","Normal Saline","Vasoactive Drugs","Balanced Crystalloids"],"sdg_mappings":[{"sdg_number":0,"sdg_label":"Good health and well-being"}],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[{"name":"refsnp"}],"source":"live","citation_network_status":"fetched"},"created_at":"2026-08-09T00:50:31.574220Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}