Initial Fluid Resuscitation Following Adjusted Body Weight Dosing in Sepsis and Septic Shock
| Autor: | Oana Antal, Monica Mleșnițe, Andrei Mihai Bălan, Natalia Hagău, Elena Ștefănescu |
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| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Resuscitation
Surviving Sepsis Campaign Septic shock business.industry RC86-88.9 Mortality rate Hemodynamics 030208 emergency & critical care medicine advanced haemodynamic monitoring Medical emergencies. Critical care. Intensive care. First aid General Medicine medicine.disease Body weight Sepsis 03 medical and health sciences 0302 clinical medicine Anesthesia medicine 030212 general & internal medicine Dosing business Research Article ideal body weight fluid adjustment |
| Zdroj: | The Journal of Critical Care Medicine, Vol 5, Iss 4, Pp 130-135 (2019) The Journal of Critical Care Medicine |
| ISSN: | 2393-1817 |
| Popis: | Introduction Fluid administration is considered a fundamental part of early sepsis treatment. Despite abundant research, fundamental questions about the amount of fluids to be given remain unanswered. Recently, the idea of adjusting the fluid load to the ideal body weight emerged, as obesity rates are increasing, and fluid overload was proven to increase mortality. Aim of the study The study aimed to determine whether advanced haemodynamic monitoring supports the adjustment of the initial fluid load to the ideal body weight (IBW). Methods Seventy-one patients with sepsis and septic shock were enrolled in the study. The initial fluid resuscitation was performed using local protocols. The haemodynamic status was assessed after the initial fluid load by transpulmonary thermos-dilution technique and the renal outcome recorded at twenty-four hours. Results 68.6% of the patients included in the study had weight disorders ranging from BMI+20% to morbid obesity. Before IBW adjustment, only 49.3% received the 30 ml/kg fluid load recommended by Surviving Sepsis Campaign Guidelines (2016) (SSC). After IBW adjustment, 70.4% received the recommended fluid dose. The difference in fluid load/kg before and after the bodyweight adjustment was statistically significant (p Conclusions Advanced haemodynamic monitoring was in favour of adjusting the initial fluid load to the IBW. There were no statistically significant differences either in the urinary output outcome at twenty-four hours, or in the twenty-eight-day mortality rates between the patients who received the 30 ml/kg IBW and those who received less than 30 ml/kg IBW. |
| Databáze: | OpenAIRE |
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