Evaluation and Predictors of Fluid Resuscitation in Patients With Severe Sepsis and Septic Shock

Rapid fluid resuscitation has become standard in sepsis care, despite " low-quality " evidence and absence of guidelines for populations " at risk " for volume overload. Our objectives include as follows: 1) identify predictors of reaching a 30 mL/kg crystalloid bolus within 3 hours of sepsis onset (30by3); 2) assess the impact of 30by3 and fluid dosing on clinical outcomes; 3) examine differences in perceived " at-risk " volume-sensitive populations, including end-stage renal disease, heart failure, obesity, advanced age, or with documentation of volume " overload " by bedside examination. Failure to reach 30by3 was associated with increased odds of in-hospital mortality, irrespective of comorbidities. Predictors of inadequate resuscitation can be identified, potentially leading to interventions to improve survival. These findings are retrospective and require future validation.
Source: Current Awareness Service for Health (CASH) - Category: Consumer Health News Source Type: news