Reducing Mortality in Severe Sepsis and Septic Shock

Andrew T. Levinson, M.D., M.P.H.; Brian P. Casserly, M.D.; Mitchell M. Levy, M.D.

Disclosures

Semin Respir Crit Care Med. 2011;32(2):195-205. 

In This Article

Fluid Therapy

In the study by Rivers et al, patients in the protocolized care group received almost 1.5 L more total fluid in the first 6 hours than those in the standard therapy group, suggesting that aggressive early fluid resuscitation to correct hypovolemia may have a significant mortality benefit.[35] Some believe that the success of EGDT therapy is primarily due to the fact that patients receive early, aggressive restoration of fluid deficits.[43] With regard to the specific type of fluid, studies have shown no difference in mortality with the use of colloids or crystalloids.[44] A large, multicenter, double-blind trial found no difference in mortality between ICU patients randomized to albumin or normal saline.[45]

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