title: Type of fluid in severe sepsis and septic shock.
abstract: Fluid resuscitation is an essential aspect of the management of patients with severe sepsis and septic shock, especially in the early stages of disease. Which fluid should be used for this purpose has been a topic of ongoing and sometimes heated debate for many years, yet this is still little evidence to support one fluid over another. Each fluid type has specific adverse effects, and all fluids when given in excess can be detrimental. In this article, we will review the advantages and limitations of the key fluid types currently used for the resuscitation of critically ill patients with sepsis, including the crystalloids (saline solutions and Ringer's lactate), and the colloids (albumin, gelatins, dextrans, and hydroxyethyl starches). We will then briefly summarize the limited evidence to support use of one fluid type over another, and provide general suggestions for fluid use in these patients.
authors.affiliation: Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles, Bruxelles, Belgium. jlvincen@ulb.ac.be
authors.forename: J-L
authors.initials: JL
authors.lastname: Vincent
authors.forename: L
authors.initials: L
authors.lastname: Gottin
mesh_terms: D000418:Albumins / Q000627:therapeutic use; D003102:Colloids / Q000627:therapeutic use; D016638:Critical Illness; D000077324:Crystalloid Solutions; D005440:Fluid Therapy / Q000379:methods*; D005780:Gelatin / Q000627:therapeutic use; D006801:Humans; D006895:Hydroxyethyl Starch Derivatives / Q000627:therapeutic use; D007552:Isotonic Solutions / Q000627:therapeutic use; D010952:Plasma Substitutes / Q000627:therapeutic use; D000077331:Ringer's Solution; D018805:Sepsis / Q000188:drug therapy*; D012772:Shock, Septic / Q000188:drug therapy*; D012965:Sodium Chloride
chemical_list: D000418:Albumins; D003102:Colloids; D000077324:Crystalloid Solutions; D006895:Hydroxyethyl Starch Derivatives; D007552:Isotonic Solutions; D010952:Plasma Substitutes; D012965:Sodium Chloride; D000077331:Ringer's Solution; D005780:Gelatin