Fluid resuscitation in sepsis: the great 30 mL per kg hoax
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Marik, Paul E.; Byrne, Liam; Van Haren, Frank
Description
Large volume fluid resuscitation is currently viewed as the cornerstone of the treatment of septic shock. The surviving sepsis campaign (SSC) guidelines provide a strong recommendation to rapidly administer a minimum of 30 mL/kg crystalloid solution intravenously in all patients with septic shock and those with elevated blood lactate levels. However, there is no credible evidence to support this recommendation. In fact, recent findings from experimental, observational and randomized clinical...[Show more]
dc.contributor.author | Marik, Paul E. | |
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dc.contributor.author | Byrne, Liam | |
dc.contributor.author | Van Haren, Frank![]() | |
dc.date.accessioned | 2021-01-08T00:52:03Z | |
dc.date.available | 2021-01-08T00:52:03Z | |
dc.identifier.issn | 2072-1439 | |
dc.identifier.uri | http://hdl.handle.net/1885/219244 | |
dc.description.abstract | Large volume fluid resuscitation is currently viewed as the cornerstone of the treatment of septic shock. The surviving sepsis campaign (SSC) guidelines provide a strong recommendation to rapidly administer a minimum of 30 mL/kg crystalloid solution intravenously in all patients with septic shock and those with elevated blood lactate levels. However, there is no credible evidence to support this recommendation. In fact, recent findings from experimental, observational and randomized clinical trials demonstrate improved outcomes with a more restrictive approach to fluid resuscitation. Accumulating evidence suggests that aggressive fluid resuscitation is harmful. Paradoxically, excess fluid administration may worsen shock. In this review, we critically evaluate the scientific evidence for a weight-based fluid resuscitation approach. Furthermore, the potential mechanisms and consequences of harm associated with fluid resuscitation are discussed. Finally, we recommend an individualized, conservative and physiologic guided approach to fluid resuscitation. | |
dc.format.mimetype | application/pdf | |
dc.language.iso | en_AU | |
dc.publisher | Pioneer Bioscience Publishing Company (PBPC) | |
dc.rights | © Journal of Thoracic Disease | |
dc.rights.uri | https://creativecommons.org/licenses/by-nc-nd/4.0/ | |
dc.source | Journal of Thoracic Disease | |
dc.title | Fluid resuscitation in sepsis: the great 30 mL per kg hoax | |
dc.type | Journal article | |
local.description.notes | Imported from ARIES | |
local.identifier.citationvolume | 12 | |
dc.date.issued | 2020 | |
local.identifier.absfor | 110310 - Intensive Care | |
local.identifier.ariespublication | a383154xPUB10819 | |
local.publisher.url | http://jtd.amegroups.com/ | |
local.type.status | Published Version | |
local.contributor.affiliation | Marik, Paul E., Eastern Virginia Medical School | |
local.contributor.affiliation | Byrne, Liam, College of Health and Medicine, ANU | |
local.contributor.affiliation | Van Haren, Frank, College of Health and Medicine, ANU | |
local.bibliographicCitation.startpage | S37 | |
local.bibliographicCitation.lastpage | S47 | |
local.identifier.doi | 10.21037/jtd.2019.12.84 | |
local.identifier.absseo | 920103 - Cardiovascular System and Diseases | |
local.identifier.absseo | 920109 - Infectious Diseases | |
dc.date.updated | 2020-11-02T04:16:38Z | |
dcterms.accessRights | Open Access | |
dc.provenance | https://v2.sherpa.ac.uk/id/publication/38122..."The Published Version can be archived in any website. CC BY-NC-ND 4.0" from SHERPA/RoMEO site (as at 8/01/2021). | |
dc.rights.license | CC BY-NC-ND 4.0 | |
Collections | ANU Research Publications |
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