Fluid boluses and infusions in the early phase of resuscitation from septic shock and sepsis-induced hypotension: a retrospective report and outcome analysis from a tertiary hospital
Authors' conclusion
This retrospective analysis of fluids given over the early phases of septic shock and sepsis-induced hypotension showed that the overall volume given by boluses ranges from about 25% on Day 1 to about 5% on Day 4 from ICU admission. Our data confirms that a positive fluid balance over the first 4 days of ICU is associated with mortality.
Study context
- Population
- Intensive care unit (ICU) patients with septic shock and sepsis-induced hypotension, 1st July 2021 to 31st December 2023
- Participants
- 220 patients
- Exposure
- Non-survivors vs Survivors
- Non-survivorsn = 66
- Outcome
- Ratio of fluids given as boluses to total fluid intake; association of fluid strategy with ICU mortality
- Follow-up
- First four days of ICU stay
Methodological detailssingle tertiary hospital, multivariable logistic regression
- Single tertiary hospital
- Multivariable logistic regression
Main finding
As reported in the abstract
Fluid boluses as share of total fluid intake · over the four days
- Boluses, % of total fluid intake over 4 days
- 8.6%
- Boluses, % of total intake, Day 1 (mean ± SD)
- 25.1% ± 24.0
- Boluses, % of total intake, Day 4 (mean ± SD)
- 4.8% ± 8.7
- Boluses and maintenance, % of overall intake
- 49.3% ± 22.8
- Balanced solution, % of overall intake
- 40.4% ± 22.0
- Drug infusion volume, % of total intake
- 34.0% ± 2.9
- Oral or nasogastric intake, % of total intake
- 18.0% ± 15.7
Observational data: associations, not effects.
Further findings
ICU mortality associated with positive fluid balance
| OR (CI) | P value | ||
|---|---|---|---|
| Positive fluid balanceMultivariable logistic regression; most important factor | 1.167 (1.029–1.341) | P = 0.021 | |
| 0.512Odds ratio (log scale) |
Overall fluid inputs, Day 1 · higher inputs only on Day 1
P = 0.022
Original publication
Fluid boluses and infusions in the early phase of resuscitation from septic shock and sepsis-induced hypotension: a retrospective report and outcome analysis from a tertiary hospital. Ann Intensive Care. Published 15 August 2024. doi:10.
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