Fluid therapy in septic shock.
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.
Rivers
Emanuel P
EP
Department of Emergency Medicine, Henry Ford Hospital, Wayne State University, Detroit, Michigan, USA. erivers1@hfhs.org
Jaehne
Anja Kathrin
AK
Eichhorn-Wharry
Laura
L
Brown
Samantha
S
Amponsah
David
D
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