The epidemiology of fluid administration, fluid accumulation and fluid balance in the critically ill and the relationship between intravenous fluid therapy and patient-centred outcomes.

Fluid resuscitation is used every day to treat unstable critically ill patients, but there is little more evidence for its use now than there was in 1832 when it was first reported. Patients who accumulate more fluid than they can eliminate tend to have worse outcomes than those who do not. This thesis explores regional and international approaches to fluid resuscitation, and national trends in fluid use. It also explores the effect of fluid resuscitation on fluid accumulation and how changes in fluid accumulation and fluid elimination impact patient outcomes.