ReviewJournal of critical care medicine (Universitatea de Medicina si Farmacie din Targu-Mures)2023
Fluids and Early Vasopressors in the Management of Septic Shock: Do We Have the Right Answers Yet?
Review in Journal of critical care medicine (Universitatea de Medicina si Farmacie din Targu-Mures), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
What it found
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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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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
17 citing papers in PubMed, 27 citations in OpenAlex.
- Hemodynamic monitoring in sepsis and septic shock in pediatric patients: a multicenter survey.Critical care science · 2026Article
- Unnecessary fluid therapy in patients with shock: Five classic fluid pitfalls and five ways to do it better.Annals of intensive care · 2026Review
- From proteomics to colloidal gold tests for urinary thrombomodulin: a prospective cohort study on accurate sepsis screening.Frontiers in cellular and infection microbiology · 2026Article
- Impact of Early versus Delayed Vasopressin Initiation on 28-Day Mortality in Older Adults with Septic Shock.Therapeutics and clinical risk management · 2026Article
- Retrospective evaluation of efficacy of CytoSorbWorld journal of critical care medicine · 2025Article
- ChronoSynthNet: a dual-task deep learning model development and validation study for predicting real-time norepinephrine dosage and the early detection of hypotension in patients with septic shock.Cardiovascular diagnosis and therapy · 2025Article
- Summary of best evidence for safe management of vasopressors through peripheral intravenous catheters.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
- Right ventricle and venous system: bridging physiology and clinical practice. A narrative review.Critical care science · 2025Review
- Review
- Recent trends in septic shock management: a narrative review of current evidence and recommendations.Annals of medicine and surgery (2012) · 2024Review
- Linear Correlation Between Mean Arterial Pressure and Urine Output in Critically Ill Patients.Critical care explorations · 2024Observational
- Steroids in the Management of Ionotropic-Resistant Septic Shock: A Comprehensive Review of Efficacy and Outcomes.Cureus · 2024Review
- Determinants of Readmission in the Intensive Care Unit: A Prospective Observational Study.Cureus · 2024Article
- The Role of Microcirculation in Haemodynamics: A Journey from Atlas to Sisyphus.Journal of critical care medicine (Universitatea de Medicina si Farmacie din Targu-Mures) · 2024Article
- Challenges in Septic Shock: From New Hemodynamics to Blood Purification Therapies.Journal of personalized medicine · 2024Review
- Validation of the echoSHOCK protocol for diagnosing the cause of shock in patients arriving at the emergency department.Turkish journal of emergency medicineArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 4 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Septic shock is a common condition associated with hypotension and organ dysfunction. It is associated with high mortality rates of up to 60% despite the best recommended resuscitation strategies in international guidelines. Patients with septic shock generally have a Mean Arterial Pressure below 65 mmHg and hypotension is the most important determinant of mortality among this group of patients. The extent and duration of hypotension are important. The two initial options that we have are 1) administration of intravenous (IV) fluids and 2) vasopressors, The current recommendation of the Surviving Sepsis Campaign guidelines to administer 30 ml/kg fluid cannot be applied to all patients. Complications of fluid over-resuscitation further delay organ recovery, prolong ICU and hospital length of stay, and increase mortality. The only reason for administering intravenous fluids in a patient with circulatory shock is to increase the mean systemic filling pressure in a patient who is volume-responsive, such that cardiac output also increases. The use of vasopressors seems to be a more appropriate strategy, the very early administration of vasopressors, preferably during the first hour after diagnosis of septic shock, may have a multimodal action and potential advantages, leading to lower morbidity and mortality in the management of septic patients. Vasopressor therapy should be initiated as soon as possible in patients with septic shock.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.