Conservative fluid therapy in septic shock

Conservative fluid therapy in septic shock: an example of targeted therapeutic minimization. Critical Care 2014, 18: 481

Chen, C. and Kollef, M.H.

http://ccforum.com/content/pdf/s13054-014-0481-5.pdf

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.