ArticleCritical care (London, England)2020
Effect of initial infusion rates of fluid resuscitation on outcomes in patients with septic shock: a historical cohort study.
Article in Critical care (London, England), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
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Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it, 54 citations in OpenAlex.
- Early fluid bolus in adults with sepsis in the emergency department: a systematic review, meta-analysis and narrative synthesis.BMC emergency medicine · 2022Pooled it
- Multiple organ dysfunction syndrome: molecular mechanisms and therapeutic strategies.Signal transduction and targeted therapy · 2026Review
- Review
- Optimal time and volume of fluid resuscitation in patients with sepsis: a nationwide multicenter cohort study.Scientific reports · 2025Article
- The Association Between Time to Completion of at Least 30 mL/kg and Hospital Outcomes Among Patients With Septic Shock.Critical care explorations · 2025Article
- Evaluating Potential Missed Opportunities to Prevent, Treat, or Diagnose Sepsis: A Population-Based Retrospective Study of Insurance Claims.Critical care explorations · 2025Article
- Dexmedetomidine plays a protective role in sepsis-associated myocardial injury by repressing PRMT5-mediated ferroptosis.Toxicology research · 2025Article
- Article
- Optimal fluid resuscitation targets in septic patients with acutely decompensated heart failure.BMC medicine · 2024Article
- A retrospective analysis of normal saline and lactated ringers as resuscitation fluid in sepsis.Frontiers in medicine · 2023Article
- Association Between Preexisting Heart Failure With Reduced Ejection Fraction and Fluid Administration Among Patients With Sepsis.JAMA network open · 2022Article
- Surviving Sepsis Guideline-Directed Fluid Resuscitation: An Assessment of Practice Patterns and Impact on Patient Outcomes.Critical care explorations · 2022Article
- Identifying factors associated with intravenous fluid administration in patients with sepsis presenting to the emergency department: a retrospective cohort study.BMC emergency medicine · 2022Article
- Impact of chloride-rich crystalloids on sepsis-associated community-acquired acute kidney injury recovery in critically ill patients.Journal of nephrology · 2022Article
- Fluid Resuscitation in Patients Presenting with Sepsis: Current Insights.Open access emergency medicine : OAEM · 2022Review
- Early combination of albumin with crystalloids administration might be beneficial for the survival of septic patients: a retrospective analysis from MIMIC-IV database.Annals of intensive care · 2021Article
- The effects of a limited infusion rate of fluid in the early resuscitation of sepsis on glycocalyx shedding measured by plasma syndecan-1: a randomized controlled trial.Journal of intensive care · 2021Article
- Fluid Therapy in Pulmonary Disease: How Careful Do We Need to Be?Frontiers in veterinary science · 2021Review
- Relationship between the rate of fluid resuscitation and acute kidney injury: A retrospective cohort study.International journal of critical illness and injury scienceArticle
Corrections and comments
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Authors and funding
8 authors at 4 institutions in 2 countries.
Funding
Abstract
backgroundFluid resuscitation has become the cornerstone of early septic shock management, but the optimal fluid rate is still not well studied. The goal of this investigation is to examine the relationship between fluid resuscitation rate and septic shock resolution.
methodWe retrospectively studied adult (≥ 18 years) patients with septic shock, defined based on sepsis III definition, from January 1, 2006, through May 31, 2018, in the medical intensive care unit (MICU) of Mayo Clinic Rochester. The fluid resuscitation time was defined as the time required to infuse the initial fluid bolus of 30 ml/kg, based on the recommendations of the 2016 surviving sepsis campaign. The cohort was divided into four groups based on the average fluid rate (group 1 ≥ 0.5, group 2 0.25-0.49, group 3 0.17-0.24, and group 4 < 0.17 ml/kg/min). The primary outcome was the time to shock reversal. Multivariable regression analyses were conducted to account for potential confounders.
resultA total of 1052 patients met eligibility criteria and were included in the analysis. The time-to-shock reversal was significantly different among the groups (P < .001). Patients in group 1 who received fluid resuscitation at a faster rate had a shorter time to shock reversal (HR = 0.78; 95% CI 0.66-0.91; P = .01) when compared with group 4 with a median (IQR) time-to-shock reversal of 1.7 (1.5, 2.0) vs. 2.8 (2.6, 3.3) days, respectively. Using 0.25 ml/kg/min as cutoff, the higher fluid infusion rate was associated with a shorter time to shock reversal (HR = 1.22; 95% CI 1.06-1.41; P = .004) and with decreased odds of 28-day mortality (HR = 0.71; 95% CI 0.60-0.85; P < .001).
conclusionIn septic shock patients, initial fluid resuscitation rate of 0.25-0.50 ml/kg/min (i.e., completion of the initial 30 ml/kg IV fluid resuscitation within the first 2 h), may be associated with early shock reversal and lower 28-day mortality compared with slower rates of infusion.
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