Choice of resuscitative fluids and mortality in emergency department patients with sepsis

Sethi, Monica; Owyang, Clark; Meyers, Chad; Parekh, Ram; Shah, Kaushal; Manini, Alex F.

doi:10.1016/j.ajem.2017.09.042

Cited by 16 publications

(15 citation statements)

References 20 publications

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“…10 juga menyatakan mortalitas tidak signifikan (p=0,77), terdapat keterbatasan jika dibanding dengan penelitian Sethi dkk. 13 (p=0,00003), yaitu Duffy dkk. 10 mengeksklusi pasien sepsis dan syok sepsis dengan komorbid sedangkan Sethi dkk.…”

Section: Hasilunclassified

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Perbedaan Pengaruh Balanced dan Unbalanced Crystalloids sebagai Terapi Cairan pada Sepsis dan Syok Sepsis: a Systematic Review

Mahendra

Cahyo

2021

jap

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Mortalitas sepsis dan syok sepsis hampir 20% per tahun dari semua kematian global. Sepsis dan syok sepsis merupakan penyebab 50% pasien dirawat di Intensive Care Unit (ICU). Kristaloid menjadi terapi cairan yang tepat menurut “The Surviving Sepsis Campaign Bundle: 2018 (SSC 2018)”. Kristaloid terbagi menjadi dua jenis, yaitu balanced dan unbalanced crystalloids. Perbedaan kandungan elektrolit keduanya dapat memengaruhi outcome pasien. Penelitian ini bertujuan mengetahui perbedaan pengaruh balanced dan unbalanced crystalloids pada sepsis dan syok sepsis dalam aspek mortalitas, kejadian hiperkloremia, dan lama tinggal di rumah sakit (RS). Metode yang digunakan adalah systematic review. Tempat penelitian berupa pencarian artikel penelitian pada online database dengan waktu penelitian, yaitu artikel dari tahun 2017 hingga 2021. Seleksi studi menggunakan PRISMA, kirteria restriksi dan PICO. Telaah artikel didapatkan 6 dari 249 artikel yang memenuhi syarat. Hasil analisis adalah mortalitas lebih rendah pada grup balanced crystalloids, kejadian hiperkloremia lebih tinggi pada unbalanced crystalloids, namun lama tinggal di RS di kedua grup tidak ada perbedaan signifikan. Simpulan penelitian adalah balanced crystalloids lebih efektif daripada unbalanced crystalloids dalam aspek menurunkan mortalitas dan kejadian hiperkloremia, namun tidak mengenai lama tinggal.

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Section: Hasilunclassified

“…Outcome lama tinggal di RS pada dua artikel, yaitu Sethi dkk. 13 dan Duffy dkk. 10 menyatakan tidak signifikan (p=0,066 dan p=0,47) meskipun lama tinggal di RS lebih lama pada grup UC dibanding dengan BC (8,4:7,9).…”

Section: Hasilunclassified

Perbedaan Pengaruh Balanced dan Unbalanced Crystalloids sebagai Terapi Cairan pada Sepsis dan Syok Sepsis: a Systematic Review

Mahendra

Cahyo

2021

jap

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“…En la última década se han publicado decenas de estudios que comparan soluciones no balanceadas con balanceadas. En la tabla 2 se resumen algunos de los más importantes en relación con la reanimación hídrica [29][30][31][32][33][34][35][36][37] .…”

Section: Coloidesunclassified

Reanimación hídrica: tipos de líquidos y efectos adversos

Merinos-Sánchez¹,

Gorordo-Delsol²,

Guamán-Crespo³

et al. 2019

REIE

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Adequate fluid resuscitation requires a deep understanding of the physiology of liquids, the mechanisms of regulation of the endothelium and the composition of each type of intravenous solution used. This work addresses the key points of the development of solutions throughout history, contrasts the physiological and pathological canons of hemodynamic and endothelial regulation of fluids, and concludes by describing the composition of various solutions, groups, beneficial and adverse effects, all on the basis of the most recent evidence from international literature.

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“…Current guidelines recommend isotonic crystalloid for volume replacement in sepsis . Saline infusion may cause hyperchloraemic acidosis, which has been associated with mortality and may be ameliorated with the use of ‘balanced’ fluids, such as Hartmann's solution . Before‐and‐after studies in the ICU and ED have associated saline with higher rates of renal dysfunction compared to balanced fluids, although no effects on renal replacement therapy or mortality were noted .…”

Section: Haemodynamic Organ Supportmentioning

confidence: 99%

“…3 Saline infusion may cause hyperchloraemic acidosis, which has been associated with mortality and may be ameliorated with the use of 'balanced' fluids, such as Hartmann's solution. 44 Before-andafter studies in the ICU and ED have associated saline with higher rates of renal dysfunction compared to balanced fluids, although no effects on renal replacement therapy or mortality were noted. 36,45 Starch-based fluids have been associated with renal impairment and excess mortality in sepsis, and are therefore not recommended.…”

Section: Fluid Typementioning

confidence: 99%

Review article: Sepsis in the emergency department – Part 3: Treatment

Williams

Keijzers

Macdonald

et al. 2018

Emerg Medicine Australasia

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Although comprehensive guidelines for treatment of sepsis exist, current research continues to refine and revise several aspects of management. Imperatives for rapid administration of broad-spectrum antibiotics for all patients with sepsis may not be supported by contemporary data. Many patients may be better served by a more judicious approach allowing consideration of investigation results and evidence-based guidelines. Conventional fluid therapy has been challenged with early evidence supporting balanced, restricted fluid and early vasopressor use. Albumin, vasopressin and hydrocortisone have each been shown to support blood pressure and reduce catecholamine requirements but without effect on mortality, and as such should be considered for ED patients with septic shock on a case-by-case basis. Measurement of quality care in sepsis should incorporate quality of blood cultures and guideline-appropriateness of antibiotics, as well as timeliness of therapy. Local audit is an essential and effective means to improve practice. Multicentre consolidation of data through agreed minimum sepsis data sets would provide baseline quality data, required for the design and evaluation of interventions.

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Choice of resuscitative fluids and mortality in emergency department patients with sepsis

Cited by 16 publications

References 20 publications

Perbedaan Pengaruh Balanced dan Unbalanced Crystalloids sebagai Terapi Cairan pada Sepsis dan Syok Sepsis: a Systematic Review

Perbedaan Pengaruh Balanced dan Unbalanced Crystalloids sebagai Terapi Cairan pada Sepsis dan Syok Sepsis: a Systematic Review

Reanimación hídrica: tipos de líquidos y efectos adversos

Review article: Sepsis in the emergency department – Part 3: Treatment

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