Which fluids are recommended for circulatory support in sepsis/septic shock?

Updated: Oct 07, 2020
  • Author: Andre Kalil, MD, MPH; Chief Editor: Michael R Pinsky, MD, CM, Dr(HC), FCCP, FAPS, MCCM  more...
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Answer

The current Surviving Sepsis guidelines recommend rapid administration of an initial fluid challenge with 30 mL/kg of crystalloid solution. [11] Albumin should be used only when substantial amounts of crystalloid solution are required. Hydroxyethyl starch solutions are not recommended. [11] (See Goals of Hemodynamic Support.) Several recent retrospective and smaller prospective clinical trials have underscored the risk that 0.9 N NaCl has as a primary resuscitation fluid. It causes hyperchloremic metabolic acidosis and is associated with an increased mortality relative to balanced salt solutions (eg, plasmalyte). [85]


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