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Critical Care
Published in: Critical Care 3/2012

Open Access 01-06-2012 | Letter

Fluid resuscitation in septic shock: too much, too little or just right?

Author: John R Prowle

Published in: Critical Care | Issue 3/2012

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Excerpt

In their interesting observational study Smith and Perner [1] describe fluid resuscitation (FR) in 164 patients with septic shock, concluding that survival was better in patients receiving higher volumes over the first 72 h. I think we should be cautious, however, to conclude from this that more is better. …
Literature
1.
Smith SH, Perner A: Higher vs. lower fluid volume for septic shock: clinical characteristics and outcome in unselected patients in a prospective, multicenter cohort. Crit Care 2012, 16: R76. 10.1186/cc11333PubMedCentralCrossRefPubMed
2.
Boyd JH, Forbes J, Nakada TA, Walley KR, Russell JA: Fluid resuscitation in septic shock: a positive fluid balance and elevated central venous pressure are associated with increased mortality. Crit Care Med 2011, 39: 259-265. 10.1097/CCM.0b013e3181feeb15CrossRefPubMed
3.
Rivers E, Nguyen B, Havstad S, Ressler J, Muzzin A, Knoblich B, Peterson E, Tomlanovich M: Early goal-directed therapy in the treatment of severe sepsis and septic shock. N Engl J Med 2001, 345: 1368-1377. 10.1056/NEJMoa010307CrossRefPubMed
4.
Jones AE, Shapiro NI, Trzeciak S, Arnold RC, Claremont HA, Kline JA, Emergency Medicine Shock Research Network I: Lactate clearance vs central venous oxygen saturation as goals of early sepsis therapy: a randomized clinical trial. JAMA 2010, 303: 739-746. 10.1001/jama.2010.158PubMedCentralCrossRefPubMed
5.
Finfer S, McEvoy S, Bellomo R, McArthur C, Myburgh J, Norton R: Impact of albumin compared to saline on organ function and mortality of patients with severe sepsis. Intensive Care Med 2011, 37: 86-96.CrossRefPubMed
6.
Perner A, Haase N, Wetterslev J, Aneman A, Tenhunen J, Guttormsen AB, Klemenzson G, Pott F, Bodker KD, Badstolokken PM, Bendtsen A, Soe-Jensen P, Tousi H, Bestle M, Pawlowicz M, Winding R, Bulow HH, Kancir C, Steensen M, Nielsen J, Fogh B, Madsen KR, Larsen NH, Carlsson M, Wiis J, Petersen JA, Iversen S, Schoidt O, Leivdal S, Berezowicz P, et al.: Comparing the effect of hydroxyethyl starch 130/0.4 with balanced crystalloid solution on mortality and kidney failure in patients with severe sepsis (6S - Scandinavian Starch for Severe Sepsis/Septic Shock trial): study protocol, design and rationale for a double-blinded, randomised clinical trial. Trials 2011, 12: 24. 10.1186/1745-6215-12-24PubMedCentralCrossRefPubMed
Metadata
Title
Fluid resuscitation in septic shock: too much, too little or just right?
Author
John R Prowle
Publication date
01-06-2012
Publisher
BioMed Central
Published in
Critical Care / Issue 3/2012
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/cc11362

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