ArticleActa anaesthesiologica Scandinavica2022
Fluid management of emergency department patients with sepsis-A survey of fluid resuscitation practices.
Article in Acta anaesthesiologica Scandinavica, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- The Implementation Gap in Early Septic Shock Resuscitation: A Three-Barrier Framework.Journal of clinical medicine · 2026Article
- A cross-sectional survey of Chinese anesthesiologists' understanding of fluid resuscitation recommendations in the 2021 surviving sepsis campaign guidelines.BMC anesthesiology · 2026Observational
- The Impact of Passive Leg Raising on Corrected Carotid Flow Time and Inferior Vena Cava Diameter Before and After Fasting: An Ultrasound-Based Cross-Sectional Study.Health science reports · 2026Article
- Passive leg raising test versus rapid fluid challenge in critically ill medical patients.Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2025Article
- Critical care nurses' knowledge, confidence, and clinical reasoning in sepsis management: a systematic review.BMC nursing · 2025Article
- Early initiated noradrenaline versus fluid therapy for hypotension and shock in the emergency department (VASOSHOCK): a protocol for a pragmatic, multi-center, superiority, randomized controlled trial.Scandinavian journal of trauma, resuscitation and emergency medicine · 2025Article
- Physician awareness of fluid volume administered with intravenous antibiotics: a structured interview-based study.Clinical and experimental emergency medicine · 2025Article
- Fluid management of emergency department patients with sepsis-A survey of fluid resuscitation practices.Acta anaesthesiologica Scandinavica · 2022Article
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Authors and funding
6 authors.
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Abstract
backgroundFluid administration and resuscitation of patients with sepsis admitted through emergency departments (ED) remains a challenge, and evidence is sparse especially in sepsis patients without shock. We aimed to investigate emergency medicine physicians' and nurses' perceptions, self-reported decision-making and daily behavior, and challenges in fluid administration of ED sepsis patients.
methodsWe developed and conducted a multicenter, web-based, cross-sectional survey focusing on fluid administration to ED patients with sepsis sent to all nurses and physicians from the five EDs in the Central Denmark Region. The survey consisted of three sections: (1) baseline information; (2) perceptions of fluid administration and daily practice; and (3) clinical scenarios about fluid administration. The survey was performed from February to June, 2021.
resultsIn total, 138 of 246 physicians (56%) and 382 of 595 nurses (64%) responded to the survey. Of total, 94% of physicians and 97% of nurses regarded fluid as an important part of sepsis treatment. Of total, 80% of physicians and 61% of nurses faced challenges regarding fluid administration in the ED, and decisions were usually based on clinical judgment. The most common challenge was the lack of guidelines for fluid administration. Of total, 96% agreed that they would like to learn more about fluid administration, and 53% requested research in fluid administration of patients with sepsis. For a normotensive patient with sepsis, 46% of physicians and 44% of nurses administered 1000 ml fluid in the first hour. Of total, 95% of physicians and 89% of nurses preferred to administer ≥1000 ml within an hour if the patients' blood pressure was 95/60 at admission. There was marked variability in responses. Blood pressure was the most commonly used trigger for fluid administration. Respondents preferred to administer less fluid if the patient in the scenario had known renal impairment or heart failure. Normal saline was the preferred fluid.
conclusionFluid administration is regarded as an important but challenging aspect of sepsis management. Responses to scenarios revealed variability in fluid volumes. Blood pressure was the most used trigger. ED nurses and physicians request evidence-based guidelines to improve fluid administration.
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