Hyperosmolar Dehydration in Sepsis: Implications for Initial Fluid Management
Main finding · 30-day mortalityResult — go to the resultAdjusted odds ratio 1.18 95% CI 1.00–1.39Authors' conclusion
Hyperosmolar dehydration at the diagnosis of sepsis was associated with increased 30-day mortality. A liberal fluid management benefits patients with hyperosmolar dehydration by improving lactate levels without increasing sequential organ failure assessment score.
Study context
- Population
- Adults with sepsis or septic shock admitted to the ICU, 20 tertiary- or university-affiliated hospitals in South Korea, September 2019–December 2021
- Participants
- 4,487 adults · 1,537 matched pairs
- Exposure
- Hyperosmolar dehydration vs no dehydration
- Hyperosmolar dehydrationn = 1,537
- Non-dehydrationn = 1,537reference
- Outcome
- 30-day mortality
- Follow-up
- 30 days
Methodological detailsnationwide, propensity-score matched (1:1), multicentre
- Nationwide
- Propensity-score matched (1:1)
- Multicentre
Main finding
As reported in the abstract
Adjusted odds ratio
1.18
95% CI 1.00–1.39
By group
Hyperosmolar dehydration vs Non-dehydration
aOR 1.18 (95% CI 1.00–1.39)
Observational data: associations, not effects.
Further findings
- Prevalence of hyperosmolar dehydration
- 58.1% · 2,605
Liberal pre-ICU fluid (>30 mL/kg), hyperosmolar dehydration subgroup
- Improved lactate levels
- P = 0.009
- No increase in SOFA score
- P = 0.111
Liberal pre-ICU fluid (>30 mL/kg), non-dehydration subgroup
- Increased SOFA score
- P = 0.034
- Higher risk of mechanical ventilation
- P < 0.001
- No improvement in lactate levels
- P = 0.388
Original publication
Hyperosmolar Dehydration in Sepsis: Implications for Initial Fluid Management. Crit Care Med. Published 8 October 2025. doi:10.
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