title: Conservative fluid therapy in septic shock: an example of targeted therapeutic minimization.
abstract: Intravenous fluids (IVFs) represent a basic therapeutic intervention utilized in septic shock. Unfortunately, the optimal method for administering IVFs to maximize patient outcomes is unknown. A meta-analysis of four randomized trials of goal-directed therapy did not demonstrate a significant reduction in mortality (odds ratio 0.609; 95% confidence interval 0.363 to 1.020; P = 0.059), whereas 18 trials with historical controls showed a significant increase in survival (odds ratio 0.580; 95% confidence interval 0.501 to 0.672; P < 0.0001). Based on these data, clinicians should be aware of the potential for harm due to the excessive administration of IVFs to patients with septic shock.
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Washington University School of Medicine, 660 South Euclid Avenue, St Louis, MO, 63110, USA. cxchen@dom.wustl.edu.
authors.forename: Catherine
authors.initials: C
authors.lastname: Chen
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Washington University School of Medicine, 660 South Euclid Avenue, St Louis, MO, 63110, USA. mkollef@dom.wustl.edu.
authors.forename: Marin H
authors.initials: MH
authors.lastname: Kollef
mesh_terms: D001826:Body Fluids / Q000502:physiology; D005440:Fluid Therapy / Q000379:methods*; D006801:Humans; D064887:Observational Studies as Topic / Q000379:methods; D016032:Randomized Controlled Trials as Topic / Q000379:methods; D012772:Shock, Septic / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy*; D016896:Treatment Outcome