What question did this study set out to answer?

To evaluate the impact of different initial fluid resuscitation doses compared to the guideline-recommended 30 cc/kg dose on lactate clearance, length of stay, costs, and mortality in sepsis.

July 1, 2023Critical Care ExplorationsOpen Access

Evaluation of the Recommended 30 cc/kg Fluid Dose for Patients With Septic Shock and Hypoperfusion With Lactate Greater Than 4 mmol/L

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Authors

SYSeife YohannesMedStar Washington Hospital Center LSLaura Piccolo SerafimMayo Clinic VSVictoria SlavinskyJohns Hopkins University

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Implication

Retrospective observational study observes no clinical benefit from standard fluid dosing variations in sepsis with elevated lactate, indicating that fluid doses exceeding 50 cc/kg increase mortality.

Key Points

To evaluate the impact of different initial fluid resuscitation doses compared to the guideline-recommended 30 cc/kg dose on lactate clearance, length of stay, costs, and mortality in sepsis.
Multicenter retrospective observational study across an eight-hospital urban healthcare system in the Northeastern United States.
Included sepsis patients with initial lactate >4 mmol/L who received appropriate antibiotics within 3 hours (N=1,491).
Stratified patients by fluid dose received within 3 hours: <15 cc/kg (n=371), 15.1–25 cc/kg (n=278), 25.1–35 cc/kg (reference group, n=316), 35.1–50 cc/kg (n=319), and >50 cc/kg (n=207) ideal body weight.
Multilinear regression showed no statistically significant differences in lactate normalization, observed-to-expected cost, or observed-to-expected length of stay between the reference cohort (25.1–35 cc/kg) and any other fluid group.
Mortality was significantly higher among patients who received fluid volumes greater than 50 cc/kg ideal body weight compared to the guideline-recommended dose group.

Cite This Study

Yohannes et al. (2023) studied this question.

synapsesocial.com/papers/6a9b86366e748ae2dbc7e6a7 https://doi.org/10.1097/cce.0000000000000932

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Evaluation of the Recommended 30 cc/kg Fluid Dose for Patients With Septic Shock and Hypoperfusion With Lactate Greater Than 4 mmol/L

Discussion

Member takes

Implication

Key Points

Cite This Study

Evaluation of the Recommended 30 cc/kg Fluid Dose for Patients With Septic Shock and Hypoperfusion With Lactate Greater Than 4 mmol/L

Discussion

Member takes

Implication

Key Points

Cite This Study

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