title: Fluid resuscitation in sepsis: reexamining the paradigm.
abstract: Sepsis results in widespread inflammatory responses altering homeostasis. Associated circulatory abnormalities (peripheral vasodilation, intravascular volume depletion, increased cellular metabolism, and myocardial depression) lead to an imbalance between oxygen delivery and demand, triggering end organ injury and failure. Fluid resuscitation is a key part of treatment, but there is little agreement on choice, amount, and end points for fluid resuscitation. Over the past few years, the safety of some fluid preparations has been questioned. Our paper highlights current concerns, reviews the science behind current practices, and aims to clarify some of the controversies surrounding fluid resuscitation in sepsis.
authors.affiliation: Cardiothoracic Intensive Care Unit, NUHS, Singapore 119074 ; National University Hospital, 5 Lower Kent Ridge Road, Singapore 119074.
authors.forename: Poorna
authors.identifier: 0000-0002-2163-9386
authors.initials: P
authors.lastname: Madhusudan
authors.affiliation: National University Hospital, 5 Lower Kent Ridge Road, Singapore 119074 ; Intensive Care Unit, NUHS, Singapore 119074.
authors.forename: Bharath Kumar
authors.initials: BK
authors.lastname: Tirupakuzhi Vijayaraghavan
authors.affiliation: Cardiothoracic Intensive Care Unit, NUHS, Singapore 119074 ; National University Hospital, 5 Lower Kent Ridge Road, Singapore 119074.
authors.forename: Matthew Edward
authors.initials: ME
authors.lastname: Cove
mesh_terms: D000465:Algorithms; D019317:Evidence-Based Medicine; D005440:Fluid Therapy / Q000379:methods*; D006801:Humans; D012151:Resuscitation / Q000379:methods*; D018805:Sepsis / Q000150:complications / Q000503:physiopathology* / Q000628:therapy*; D016896:Treatment Outcome; D014883:Water-Electrolyte Imbalance / Q000209:etiology / Q000503:physiopathology* / Q000628:therapy*