[The effect of different fluids on early fluid resuscitation in septic shock].
OBJECTIVE
To study the effects of different fluids on blood pressure (BP), blood lactate clearance and mortality in patients with septic shock after early fluid resuscitation.


METHODS
Sixty patients were enrolled and randomly divided into four groups according to the fluids used in resuscitation: normal saline (NS) group (15 cases), hydroxyethyl starch (HES) group (15 cases), 4% hypertonic saline solution (4%NaCl) group (15 cases), hypertonic sodium chloride hydroxyethyl starch 40 solution (HSH40) group, (15 cases). Patients of different groups received fluid resuscitation via central vein, at the same time, received the anti-shock treatment. Hemodynamic parameters, blood lactate clearance and mortality in patients were monitored after resuscitation.


RESULTS
The study fluid volume and the total fluid volume in the 4%NaCl group and HSH40 group was lower than that in NS group and HES group significantly (all P<0.01). The mean arterial pressure (MAP) in HSH40 group was significantly higher than in the other three groups 1 hour after the fluid resuscitation (all P<0.01). The 24-hour blood lactate clearance in HSH40 group was also higher than in the other three groups (all P<0.01). The scores of sepsis-related organ failure assessment (SOFA) scores, acute physiology and chronic health evaluation II (APACHE II) scores, and 28-day mortality showed no significant differences among these groups (all P>0.05), but a lowering trend on 28-day mortality could be observed in HSH40 group.


CONCLUSIONS
The rapid elevation of BP can improve blood lactate clearance in patients with septic shock receiving early fluid resuscitation. Compared with other fluids, HSH40 raises BP more quickly and needs lower total resuscitation volume to achieve the same goal.
Li
Feng
F
Intensive Care Unit, The Second Affiliated Hospital of Nantong University, Nantong 226001, Jiang su, China.
Sun
Hua
H
Han
Xu-dong
XD
D000293:Adolescent; D000328:Adult; D000368:Aged; D001794:Blood Pressure / Q000187:drug effects; D005260:Female; D005440:Fluid Therapy / Q000379:methods*; D006801:Humans; D006895:Hydroxyethyl Starch Derivatives / Q000008:administration & dosage; D019344:Lactic Acid / Q000097:blood; D008297:Male; D008875:Middle Aged; D010952:Plasma Substitutes / Q000008:administration & dosage*; D012151:Resuscitation; D012462:Saline Solution, Hypertonic / Q000008:administration & dosage; D012772:Shock, Septic / Q000097:blood / Q000503:physiopathology / Q000628:therapy*; D055815:Young Adult
D006895:Hydroxyethyl Starch Derivatives; D010952:Plasma Substitutes; D012462:Saline Solution, Hypertonic; D019344:Lactic Acid