title: Fluid therapy in septic shock.
abstract: OBJECTIVE
  To examine the role of fluid therapy in the pathogenesis of severe sepsis and septic shock. The type, composition, titration, management strategies and complications of fluid administration will be examined in respect to outcomes.
  
  
  RESULTS
  Fluids have a critical role in the pathogenesis and treatment of early resuscitation of severe sepsis and septic shock.
  
  
  CONCLUSIONS
  Although this pathogenesis is evolving, early titrated fluid administration modulates inflammation, improves microvascular perfusion, impacts organ function and outcome. Fluid administration has limited impact on tissue perfusion during the later stages of sepsis and excess fluid is deleterious to outcome. The type of fluid solution does not seem to influence these observations.
authors.affiliation: Department of Emergency Medicine, Henry Ford Hospital, Wayne State University, Detroit, Michigan, USA. erivers1@hfhs.org
authors.forename: Emanuel P
authors.initials: EP
authors.lastname: Rivers
authors.forename: Anja Kathrin
authors.initials: AK
authors.lastname: Jaehne
authors.forename: Laura
authors.initials: L
authors.lastname: Eichhorn-Wharry
authors.forename: Samantha
authors.initials: S
authors.lastname: Brown
authors.forename: David
authors.initials: D
authors.lastname: Amponsah
mesh_terms: D005440:Fluid Therapy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D020896:Hypovolemia / Q000628:therapy*; D010477:Perfusion; D012151:Resuscitation / Q000379:methods; D018805:Sepsis / Q000628:therapy*; D012772:Shock, Septic / Q000628:therapy*; D016896:Treatment Outcome