Fluid therapy remains one of the most common, powerful, and potentially hazardous interventions in intensive care. For decades, clinicians have understood that both under-resuscitation and over-resuscitation can harm critically ill patients. Yet the field has struggled with a deceptively simple question: how much fluid imbalance is clinically meaningful? The observational cohort study by Hofer and colleagues, “Weight-adjusted fluid balance and its impact on days alive without life support in critical illness,” addresses this question by linking cumulative weight-adjusted fluid balance at day 3 after ICU admission to days alive without life support.
