Resuscitation Targets, Fluids, and Vasoactives in Septic Shock.

Jeffrey D Graham, Michael J Lanspa, Ithan D Peltan

Abstract readReview

In one paragraph

Review in Clinics in chest medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it

0cells of the map it votes in

1citing papers in PubMed

–field-weighted citation impact

1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

Pathological triad of perioperative acute kidney injury: renal microcirculatory hypoxia, mitochondrial damage, and immuno-metabolic reprogramming.Frontiers in immunology · 2026
Review

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Jeffrey D GrahamDepartment of Pulmonary and Critical Care Medicine, Shock Trauma Intensive Care Unit (T5), Intermountain Medical Center, 5121 South Cottonwood Street, Salt Lake City, UT 84107, USA.

Michael J LanspaDepartment of Pulmonary and Critical Care Medicine, Shock Trauma Intensive Care Unit (T5), Intermountain Medical Center, 5121 South Cottonwood Street, Salt Lake City, UT 84107, USA.

Ithan D PeltanDepartment of Pulmonary and Critical Care Medicine, Shock Trauma Intensive Care Unit (T5), Intermountain Medical Center, 5121 South Cottonwood Street, Salt Lake City, UT 84107, USA. Electronic address: ithan.peltan@imail.org.

Funding

Measuring and Learning from Care Variation in SepsisR35GM151147 · NIGMS · IHC HEALTH SERVICES, INC. · PI Ithan Daniel Peltan · 2023 to 2026

$1.5M

NIGMS NIH HHS R35 GM151147

6 · The paper itself

Abstract

Intravenous fluids and vasoactive medications represent the foundation of hemodynamic resuscitation for septic shock. Based on current evidence, initial fluid resuscitation of roughly 30 mL/kg with balanced crystalloids is reasonable for most patients. Carefully monitored peripheral vein administration of the first-line vasopressor, norepinephrine, appears safe. Ongoing multimodal assessment and therapy titration integrating blood pressure, lactate clearance, capillary refill time, and dynamic measures of fluid responsiveness yields outcomes equivalent to protocolized goal-directed resuscitation. However, better evidence is urgently needed for many common septic shock management issues.

Indexed as

Fluid TherapyResuscitationShock, SepticVasoconstrictor AgentsCrystalloid SolutionsHumansIsotonic SolutionsCrystalloid SolutionsIsotonic SolutionsVasoconstrictor AgentsBalanced crystalloidsCapillary refill timeDynamic fluid responsiveness assessmentIntravenous fluid resuscitationPeripheral vasopressorsResuscitation targetsSeptic shockVasopressor selection

Identifiers

PMID41651598

DOI10.1016/j.ccm.2025.10.003

PMCPMC12917878

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Registered trials

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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.