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Critical Care
Published in: Critical Care 1/2012

01-02-2012 | Viewpoint

A critique of fluid bolus resuscitation in severe sepsis

Authors: Andrew K Hilton, Rinaldo Bellomo

Published in: Critical Care | Issue 1/2012

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Abstract

Resuscitation of septic patients by means of one or more fluid boluses is recommended by guidelines from multiple relevant organizations and as a component of surviving sepsis campaigns. The technique is considered a key and life-saving intervention during the initial treatment of severe sepsis in children and adults. Such recommendations, however, are only based on expert opinion and lack adequate experimental or controlled human evidence. Despite these limitations, fluid bolus therapy (20 to 40 ml/kg) is widely practiced and is currently considered a cornerstone of the management of sepsis. In this pointof-view critique, we will argue that such therapy has weak physiological support, has limited experimental support, and is at odds with emerging observational data in several subgroups of critically ill patients or those having major abdominal surgery. Finally, we will argue that this paradigm is now challenged by the findings of a large randomized controlled trial in septic children. In the present article, we contend that the concept of large fluid bolus resuscitation in sepsis needs to be investigated further.
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Metadata
Title
A critique of fluid bolus resuscitation in severe sepsis
Authors
Andrew K Hilton
Rinaldo Bellomo
Publication date
01-02-2012
Publisher
BioMed Central
Published in
Critical Care / Issue 1/2012
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/cc11154

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