<abstract xmlns="http://www.w3.org/1999/xhtml"><sec id="j_jccm-2019-0025_s_006_w2aab3b7b7b1b6b1aab1c18b1Aa"><h3>Introduction</h3><p>Fluid administration is considered a fundamental part of early sepsis treatment. Despite abundant research, fundamental questions about the amount of fluids to be given remain unanswered. Recently, the idea of adjusting the fluid load to the ideal body weight emerged, as obesity rates are increasing, and fluid overload was proven to increase mortality.</p></sec><sec id="j_jccm-2019-0025_s_007_w2aab3b7b7b1b6b1aab1c18b2Aa"><h3>Aim of the study</h3><p>The study aimed to determine whether advanced haemodynamic monitoring supports the adjustment of the initial fluid load to the ideal body weight (IBW).</p></sec><sec id="j_jccm-2019-0025_s_008_w2aab3b7b7b1b6b1aab1c18b3Aa"><h3>Methods</h3><p>Seventy-one patients with sepsis and septic shock were enrolled in the study. The initial fluid resuscitation was performed using local protocols. The haemodynamic status was assessed after the initial fluid load by transpulmonary thermos-dilution technique and the renal outcome recorded at twenty-four hours.</p></sec><sec id="j_jccm-2019-0025_s_009_w2aab3b7b7b1b6b1aab1c18b4Aa"><h3>Results</h3><p>68.6% of the patients included in the study had weight disorders ranging from BMI+20% to morbid obesity. Before IBW adjustment, only 49.3% received the 30 ml/kg fluid load recommended by Surviving Sepsis Campaign Guidelines (2016) (SSC). After IBW adjustment, 70.4% received the recommended fluid dose. The difference in fluid load/kg before and after the bodyweight adjustment was statistically significant (p&lt;0.01). After the initial fluid load, the majority of the macro haemodynamic parameters were in the targeted range. There was no statistically significant difference between the urinary output outcome at 24 hours or the 28 days mortality rates between the patients resuscitated by the SSC and those who received less fluid.</p></sec><sec id="j_jccm-2019-0025_s_010_w2aab3b7b7b1b6b1aab1c18b5Aa"><h3>Conclusions</h3><p>Advanced haemodynamic monitoring was in favour of adjusting the initial fluid load to the IBW. There were no statistically significant differences either in the urinary output outcome at twenty-four hours, or in the twenty-eight-day mortality rates between the patients who received the 30 ml/kg IBW and those who received less than 30 ml/kg IBW.</p></sec></abstract>

IntroductionFluid administration is considered a fundamental part of early sepsis treatment. Despite abundant research, fundamental questions about the amount of fluids to be given remain unanswered. Recently, the idea of adjusting the fluid load to the ideal body weight emerged, as obesity rates are increasing, and fluid overload was proven to increase mortality.Aim of the studyThe study aimed to determine whether advanced haemodynamic monitoring supports the adjustment of the initial fluid load to the ideal body weight (IBW).MethodsSeventy-one patients with sepsis and septic shock were enrolled in the study. The initial fluid resuscitation was performed using local protocols. The haemodynamic status was assessed after the initial fluid load by transpulmonary thermos-dilution technique and the renal outcome recorded at twenty-four hours.Results68.6% of the patients included in the study had weight disorders ranging from BMI+20% to morbid obesity. Before IBW adjustment, only 49.3% received the 30 ml/kg fluid load recommended by Surviving Sepsis Campaign Guidelines (2016) (SSC). After IBW adjustment, 70.4% received the recommended fluid dose. The difference in fluid load/kg before and after the bodyweight adjustment was statistically significant (p<0.01). After the initial fluid load, the majority of the macro haemodynamic parameters were in the targeted range. There was no statistically significant difference between the urinary output outcome at 24 hours or the 28 days mortality rates between the patients resuscitated by the SSC and those who received less fluid.ConclusionsAdvanced haemodynamic monitoring was in favour of adjusting the initial fluid load to the IBW. There were no statistically significant differences either in the urinary output outcome at twenty-four hours, or in the twenty-eight-day mortality rates between the patients who received the 30 ml/kg IBW and those who received less than 30 ml/kg IBW.

Initial Fluid Resuscitation Following Adjusted Body Weight Dosing in Sepsis and Septic Shock

The Journal of Critical Care Medicine

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

IntroductionFluid administration is considered a fundamental part of early sepsis treatment. Despite abundant research, fundamental questions about the amount...

Initial Fluid Resuscitation Following Adjusted Body Weight Dosing in Sepsis and Septic Shock

Article Category: Research Article

Publié en ligne: 27 nov. 2019

Pages: 130 - 135

Reçu: 01 juin 2019

Accepté: 28 oct. 2019

DOI: https://doi.org/10.2478/jccm-2019-0025

Mots clés
ideal body weight fluid adjustment, advanced haemodynamic monitoring

© 2019 Oana Antal, Elena Ștefănescu, Monica Mleșnițe, Andrei Mihai Bălan, Natalia Hagău, published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

Initial Fluid Resuscitation Following Adjusted Body Weight Dosing in Sepsis and Septic Shock

Article Category: Research Article

Publié en ligne: 27 nov. 2019

Pages: 130 - 135

Reçu: 01 juin 2019

Accepté: 28 oct. 2019

DOI: https://doi.org/10.2478/jccm-2019-0025

Mots clésideal body weight fluid adjustment, advanced haemodynamic monitoring

© 2019 Oana Antal, Elena Ștefănescu, Monica Mleșnițe, Andrei Mihai Bălan, Natalia Hagău, published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

Mots clés
ideal body weight fluid adjustment, advanced haemodynamic monitoring