Intravenous fluids are the usual treatment for shock caused by loss of blood, but adding extra fluid to the circulation can overload a damaged heart that already has a reduced output, so that the shock deepens.
"Glucose bypasses the liver and goes into systemic circulation, whereas fructose overloads the liver and gets turned into liver fat, which then increases blood triglycerides, cholesterol and the risk of cardiovascular disease," said Stanhope.
During WLL, an unpredictable volume of saline can be absorbed which may also overload the circulation.
Patients with aortic stenosis, who normalized the left ventricular mass (LVM) one year after aortic valve replacement (AVR), exhibited preoperative high levels of circulating miR-133a, compared with patients who presented residual hypertrophy, probably as a consequence of its release by the myocardium into the circulation in the pressure overload condition [ 153].
Fluid restriction may decrease circulating blood volume and the overload of the pulmonary circulation that in turn may improve the respiratory function [ 117].
Beyond that, especially direct double-tracer measurements that compared overloading a normovolemic circulation (hypervolemia) to replacement of acute blood losses have revealed that colloidal volume effects might not be consistent, but context-sensitive [ 19].
That absence of bleeding, circulatory system diagnoses, and admission for surgical reasons were associated with fluid overload is logical; the circulation is more easily overloaded when it is normovolemic to begin with, and patients with cardiovascular disease typically receive large volume transfusions perioperatively.
Moreover, apoptotic defects and impaired removal of apoptotic cells could contribute to an overload of autoantigens in the circulation or in target tissues that could become available to initiate an autoimmune response [ 29].
These changes that lead to a lipid overload of monocytes already in the circulation may promote the formation of local inflammatory sites that favour the onset of atherosclerosis.
In large defects, there is usually a volume overload of the right ventricle, the pulmonary circulation and eventually the left atrium and left ventricle.
One of the major arguments for the use of salt-poor albumin in resuscitation is that the circulation might be maintained without incurring a large interstitial salt overload.
