Purpose: This is the frst of three parts of the clinical practice guideline from the European Society of Intensive Care  Medicine (ESICM) on resuscitation fuids in adult critically ill patients. This part addresses fuid choice and the other  two will separately address fuid amount and fuid removal. 

Methods: This guideline was formulated by an international panel of clinical experts and methodologists. The Grad‑ ing of Recommendations Assessment, Development, and Evaluation (GRADE) methodology was applied to evaluate  the certainty of evidence and to move from evidence to decision. 

Results: For volume expansion, the guideline provides conditional recommendations for using crystalloids rather  than albumin in critically ill patients in general (moderate certainty of evidence), in patients with sepsis (moderate  certainty of evidence), in patients with acute respiratory failure (very low certainty of evidence) and in patients in the  perioperative period and patients at risk for bleeding (very low certainty of evidence). There is a conditional recom‑ mendation for using isotonic saline rather than albumin in patients with traumatic brain injury (very low certainty of  evidence). There is a conditional recommendation for using albumin rather than crystalloids in patients with cirrhosis  (very low certainty of evidence). The guideline provides conditional recommendations for using balanced crystalloids  rather than isotonic saline in critically ill patients in general (low certainty of evidence), in patients with sepsis (low  certainty of evidence) and in patients with kidney injury (very low certainty of evidence). There is a conditional recom‑ mendation for using isotonic saline rather than balanced crystalloids in patients with traumatic brain injury (very low  certainty of evidence). There is a conditional recommendation for using isotonic crystalloids rather than small-volume  hypertonic crystalloids in critically ill patients in general (very low certainty of evidence).

Conclusions: This guideline provides eleven recommendations to inform clinicians on resuscitation fuid choice in  critically ill patients

目的：这是欧洲重症医学会（ESICM）关于成年危重病人复苏燃料临床实践指南三个部分中的第一部分。这一部分涉及到胰岛素的选择，另外两部分将分别涉及到胰岛素的用量和胰岛素的清除。

方法：该指南由一个由临床专家和方法论专家组成的国际小组制定。采用建议评估、发展和评价分级法（GRADE）评估证据的确定性，并将证据转化为决策。

结果：在扩容方面，指南有条件地建议在一般重症患者（中度证据确定性）、脓毒症患者（中度证据确定性）、急性呼吸衰竭患者（极低证据确定性）以及围手术期患者和有出血风险的患者（极低证据确定性）中使用晶体液而非白蛋白。有条件建议在脑外伤患者中使用等渗盐水而非白蛋白（证据确定性极低）。有条件建议肝硬化患者使用白蛋白而非晶体液（证据确定性极低）。该指南有条件地建议在一般重症患者（证据确定性低）、败血症患者（证据确定性低）和肾损伤患者（证据确定性极低）中使用平衡晶体液而不是等渗盐水。有条件建议在脑外伤患者中使用等渗盐水而非平衡晶体液（证据确定性极低）。有条件建议在一般重症患者中使用等渗晶体液而非小容量高渗晶体液（证据确定性极低）。

结论：本指南提供了11项建议，为临床医生选择重症患者复苏液体提供了依据。