ArticleCritical care explorations2023
Evaluation of the Recommended 30 cc/kg Fluid Dose for Patients With Septic Shock and Hypoperfusion With Lactate Greater Than 4 mmol/L.
Article in Critical care explorations, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
4 citing papers in PubMed.
- Effects of early use of norepinephrine combined with esmolol on hemodynamic stability and 28-day mortality in patients with septic shock.BMC infectious diseases · 2026Article
- The Physiology, Pathophysiology, and Clinical Implications of Fluid Resuscitation in Critically Ill Patients.Cureus · 2026Review
- Lactate Clearance of the Adsorber CytosorbBiomedicines · 2025Article
- Sepsis in obstetric care for the emergency clinician: A review.Seminars in perinatology · 2024Review
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The Surviving Sepsis Campaign Guidelines recommend fluid administration of 30 cc/kg ideal body weight (IBW) for patients with sepsis and lactate greater than 4 mmol/L within 3 hours of identification. In this study, we explore the impact of fluid dose on lactate normalization, treatment cost, length of stay, and mortality in patients with lactate greater than 4.
designMulticenter retrospective observational study.
settingEight-hospital urban healthcare system in Northeastern United States. PATIENTS: Patients with sepsis, initial lactate value greater than 4 mmol/L, and received appropriate antibiotics within 3 hours.
interventionsNone. MEASUREMENTS AND MAIN
resultsWe stratified patients into five groups based on the dose of fluid administered within 3 hours after sepsis identification. The groupings were less than 15 cc/kg IBW, 15.1-25 cc/kg IBW, 25.1-35 cc/kg IBW, 35.1-50 cc/kg IBW, and greater than 50 cc/kg IBW. We used the group that received a fluid dose of 25.1-35 cc/kg IBW, as a reference group. The mean age was 66 years, and 56% were male. Three hundred seventy-one (25%) received less than 15 cc/kg of IBW of crystalloid fluid, 278 (17%) received 15-25 cc/kg of IBW, 316 (21%) received 25.1-35 cc/kg of IBW, 319 (21%) received 35.1-50 cc/kg of IBW, and 207 (14%) received greater than 50 cc/kg of IBW. After multilinear regression, there was no significant difference in lactate normalization between the reference group and any of the other fluid groups. We also found no statistically significant difference in the observed/expected cost, or observed/expected length of stay, between the reference group and any of the other fluid groups. Mortality was higher among patients who received greater than 50 cc/kg IBW when compared to the recommended dose.
conclusionsIn patients with sepsis and lactate value greater than 4 mmol/L, high or low fluid doses were not associated with better lactate clearance or patient outcomes. Greater than 50 cc/kg IBW dose of fluids within 3 hours is associated with higher mortality.
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