Post Resusicitation Fluid Boluses in Severe Sepsis or Septic Shock

Bihari, Shailesh; Prakash, Shivesh; Bersten, Andrew D.

doi:10.1097/shk.0b013e31829727f1

Cited by 63 publications

(61 citation statements)

References 35 publications

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“…The use of post-resuscitation fluid boluses of any kind in sepsis has limited success and may be harmful. Bihari et al studied 184 fluid boluses in 50 patients with sepsis after initial resuscitation and found minimal increase in MAP and urine output following a fluid bolus in this context, yet a significant decrease in the PaO 2 /FiO 2 ratio [70].…”

Section: Recent Studies Of Gdft Within An Enhanced Recovery Programmentioning

confidence: 99%

State-of-the-art fluid management in the operating room

Miller

Raghunathan

Gan

2014

Best Practice & Research Clinical Anaesthesiology

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The underlying principles guiding fluid management in any setting are very simple: maintain central euvolemia, and avoid salt and water excess. However, these principles are frequently easier to state than to achieve. Evidence from recent literature suggests that avoidance of fluid excess is important, with excessive crystalloid use leading to perioperative weight gain and an increase in complications. A zero-balance approach aimed at avoiding fluid excess is recommended for all patients. For major surgery, there is a sizeable body of evidence that an individualized goal-directed fluid therapy (GDFT) improves outcomes. However, within an Enhanced Recovery program only a few studies have been published, yet so far GDFT has not achieved the same benefit. Balanced crystalloids are recommended for most patients. The use of colloids remains controversial; however, current evidence suggests they can be beneficial in intraoperative patients with objective evidence of hypovolemia.

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Section: Recent Studies Of Gdft Within An Enhanced Recovery Programmentioning

confidence: 99%

State-of-the-art fluid management in the operating room

Miller

Raghunathan

Gan

2014

Best Practice & Research Clinical Anaesthesiology

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“…As the absence of calcium and high chloride levels in 4 % albumin (CSL Biotherapies; which contains the following: sodium 140 mmol/l, chloride 128 mmol/l, albumin 40 g/l and octanoate 6.4 mmol/l) may lead to clinically significant effects, we further analysed data from our recently conducted price study [1], after 149 fluid boluses with 4 % albumin administration. The amount of 4 % albumin administered was 500 (250-500) ml [median (IQR)] and acid-base status and serum electrolytes were analysed with an ABL700 series (Radiometer Medical ApS, Brønshøj, Denmark) before and 1 h after fluid administration.…”

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confidence: 99%

Early changes in serum electrolytes and acid–base status with administration of 4 % albumin

2014

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“…Multiple studies have demonstrated harm with standardizing liberal fluid resuscitation, notably when given beyond the initial hours of EGDT. [16][17][18][19] On the contrary, anecdotal experience and a few studies show the benefit of out-of-hospital fluid resuscitation by emergency medical services, which suggest that early fluid resuscitation might be better. 20,21 The present study is the first, to our knowledge, to examine the timing of fluid resuscitation in patients with severe sepsis and septic shock within the first 6 h in the ICU.…”

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confidence: 99%