ArticlePloS one2021
Fluid resuscitation and outcomes in heart failure patients with severe sepsis or septic shock: A retrospective case-control study.
Article in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it, 28 citations in OpenAlex.
- European Society of Intensive Care Medicine (ESICM) 2025 clinical practice guideline on fluid therapy in adult critically ill patients: part 2-the volume of resuscitation fluids.Intensive care medicine · 2025Guideline
- The Physiology, Pathophysiology, and Clinical Implications of Fluid Resuscitation in Critically Ill Patients.Cureus · 2026Review
- Mortality Trends in the United States due to Concurrent Heart Failure, Atrial Fibrillation/Flutter, and Sepsis.medRxiv : the preprint server for health sciences · 2026Article
- Evidence-based fluid resuscitation of the septic HFpEF patient: A narrative review of the literature.Journal of critical care medicine (Universitatea de Medicina si Farmacie din Targu-Mures) · 2026Review
- Mortality Trends in the United States due to Concurrent Heart Failure, Atrial Fibrillation/Flutter and Sepsis.Cardiology and cardiovascular medicine · 2026Article
- Association of pre-exiting heart failure with long-term mortality and the recurrence of sepsis.Scientific reports · 2025Article
- Optimal fluid resuscitation targets in septic patients with acutely decompensated heart failure.BMC medicine · 2024Article
- Article
- Associations Between Volume of Early Intravenous Fluid and Hospital Outcomes in Septic Patients With and Without Heart Failure: A Retrospective Cohort Study.Critical care explorations · 2024Article
- Does Point-of-Care Ultrasound Affect Fluid Resuscitation Volume in Patients with Septic Shock: A Retrospective Review.Emergency medicine international · 2024Article
- Association Between Preexisting Heart Failure With Reduced Ejection Fraction and Fluid Administration Among Patients With Sepsis.JAMA network open · 2022Article
- Early Diuretics for De-resuscitation in Septic Patients With Left Ventricular Dysfunction.Clinical Medicine Insights. Cardiology · 2022Article
- Fluid overload and mortality in critically ill patients with severe heart failure and cardiogenic shock-An observational cohort study.Frontiers in medicine · 2022Article
- The Relationship between Serum CXCL8 and ET-1 Expression Levels and Sepsis Complicated with Heart Failure.Cardiology research and practice · 2022Article
Corrections and comments
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Authors and funding
9 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe use of ≥30 mL/Kg fluid bolus in congestive heart failure (CHF) patients presenting with severe sepsis or septic shock remained controversial due to the paucity of data.
methodsThe retrospective case-control study included 671 adult patients who presented to the emergency department of a tertiary care hospital from January 01, 2017 to December 31, 2019 with severe sepsis or septic shock. Patients were categorized into the CHF group and the non-CHF group. The primary outcome was to evaluate the compliance with ≥30 mL/Kg fluid bolus within 6 hours of presentation. The comparison of baseline characteristics and secondary outcomes were done between the groups who received ≥30 mL/Kg fluid bolus. For the subgroup analysis of the CHF group, it was divided based on if they received ≥30 mL/Kg fluid bolus or not, and comparison was done for baseline characteristics and secondary outcomes. Univariate and multivariable analyses were performed to explore the differences between the groups for in-hospital mortality and mechanical ventilation.
resultsThe use of ≥30 mL/Kg fluid bolus was low in both the CHF and non-CHF groups [39% vs. 66% (p<0.05)]. Mortality was higher in the CHF group [33% vs 18% (p<0.05)]. Multivariable analysis revealed that the use of ≥30 mL/Kg fluid bolus decreased the chances of mortality by 12% [OR 0.88, 95% CI 0.82-0.95 (p<0.05)]. The use of ≥30 mL/Kg fluid bolus did not increase the odds of mechanical ventilation [OR 0.99, 95% CI 0.93-1.05 (p = 0.78)]. In subgroup analysis, the use of ≥30 mL/Kg fluid bolus decreased the chances of mortality by 5% [OR 0.95, 95% CI 0.90-0.99, (p<0.05)] and did not increase the odds of mechanical ventilation. The presence of the low ejection fraction did not influence the chance of getting fluid bolus.
conclusionThe use of ≥30 mL/Kg fluid bolus seems to confer protection against in-hospital mortality and is not associated with increased chances of mechanical ventilation in heart failure patients presenting with severe sepsis or septic shock.
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