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

Critical Care Medicine
Hani I KuttabMichael A Ward

Abstract

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. Retrospective cohort study. All outcome analyses controlled for sex, end-stage renal disease, heart failure, sepsis severity (severe sepsis vs septic shock), obesity, Mortality in Emergency Department Sepsis score, and time to antibiotics. Urban, tertiary care center between January 1, 2014, and May 31, 2017. Emergency Department treated adults (age ≥18 yr; n = 1,032) with severe sepsis or septic shock. Administration of IV fluids by bolus. In total, 509 patients received 30by3 (49.3%). Overall mortality was 17.1% (n = 176), with 20.4% mortality in the shock group. Patients who were elderly (odds ratio, 0.62; 95% CI, 0.46-0.83), male (odds ratio, 0....Continue Reading

References

Jan 17, 2002·The New England Journal of Medicine·E RiversUNKNOWN Early Goal-Directed Therapy Collaborative Group
May 23, 2006·The New England Journal of Medicine·UNKNOWN National Heart, Lung, and Blood Institute Acute Respiratory Distress Syndrome (ARDS) Clinical Trials NetworkAndrea L Harabin
Jun 24, 2011·Science Translational Medicine·Neil M GoldenbergWarren L Lee
Jul 20, 2012·Critical Care Medicine·Rinaldo BellomoUNKNOWN Vital Signs to Identify, Target, and Assess Level of Care Study (VITAL Care Study) Investigators
Apr 19, 2013·Critical Care : the Official Journal of the Critical Care Forum·Yaseen M ArabiUNKNOWN Cooperative Antimicrobial Therapy of Septic Shock (CATSS) Database Research Group
Jun 12, 2013·JAMA Internal Medicine·Matthijs Kox, Peter Pickkers
Jun 22, 2013·Critical Care : the Official Journal of the Critical Care Forum·Petch WacharasintKeith R Walley
Mar 19, 2014·The New England Journal of Medicine·Donald M YealyDerek C Angus
Apr 22, 2014·Annals of Emergency Medicine·Amy H KajiSteven Green
Oct 2, 2014·The New England Journal of Medicine·Sandra L PeakePatricia Williams
Oct 3, 2014·Critical Care Medicine·Mitchell M LevyR Phillip Dellinger
Mar 18, 2015·The New England Journal of Medicine·Paul R MounceyUNKNOWN ProMISe Trial Investigators
Oct 16, 2015·BMC Emergency Medicine·Gilbert Abou DagherRalphe Bou Chebl
Dec 24, 2015·American Journal of Respiratory and Critical Care Medicine·Vincent X LiuAlan Whippy
Dec 7, 2016·Critical Care Medicine·Yasser SakrUNKNOWN Intensive Care Over Nations Investigators
Apr 7, 2017·Statistics in Medicine·Per K AndersenErik T Parner
May 23, 2017·The New England Journal of Medicine·Christopher W SeymourMitchell M Levy
Jul 15, 2017·Critical Care : the Official Journal of the Critical Care Forum·Pär Ingemar JohanssonSisse Rye Ostrowski
Oct 4, 2017·JAMA : the Journal of the American Medical Association·Ben AndrewsGordon R Bernard

❮ Previous
Next ❯

Citations

Feb 15, 2020·Critical Care Medicine·Hani I Kuttab, Michael A Ward
Jun 5, 2020·Journal of Intensive Care Medicine·Timothy W JonesAndrea Sikora Newsome
Apr 9, 2020·Critical Care : the Official Journal of the Critical Care Forum·Bo HuKianoush Kashani
Nov 21, 2020·Journal of Intensive Care Medicine·Michael A WardJohn Purakal
Jan 14, 2021·Critical Care Medicine·Erron M RourkeMichael A Ward
Jan 14, 2021·Critical Care Medicine·Timothy W JonesAndrea Sikora Newsome
Sep 29, 2020·Emergency Medicine Clinics of North America·Sara Manning
Mar 31, 2021·The American Journal of Emergency Medicine·Joseph D Lykins VMichael A Ward
May 11, 2021·World Journal of Clinical Cases·He-Ping XuYan-Hong Ouyang
Oct 22, 2020·Mayo Clinic Proceedings. Innovations, Quality & Outcomes·Andreas H TaenzerUNKNOWN Members of the High Value Healthcare Collaborative

❮ Previous
Next ❯

Related Concepts

Related Feeds

Cardiovascular Diseases: Risk Factors

Cardiovascular disease is a significant health concern. Risk factors include hypertension, obesity, dyslipidemia and smoking. Women who are postmenopausal are at an increased risk of heart disease. Here is the latest research for risk factors of cardiovascular disease.