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Conservative fluid therapy in septic shock: an example of targeted therapeutic minimization.

Chen, Catherine; Kollef, Marin H.
Crit Care; 18(4): 481, 2014 Aug 29.
Artigo em Inglês | MEDLINE | Set 2014 | ID: mdl-25185073
Resumo: Intravenous fluids (IVFs) represent a basic therapeutic intervention utilized in septic shock. Unfortunately, the optimal method for administering IVFs to maximize patient outcomes is unknown. A meta-analysis of four randomized trials of goal-directed therapy did not demonstrate a significant reduction in mortality (odds ratio 0.609; 95% confidence interval 0.363 to 1.020; P = 0.059), whereas 18 trials with historical controls showed a significant increase in survival (odds ratio 0.580; 95% confidence interval 0.501 to 0.672; P < 0.0001). Based on these data, clinicians should be aware of the potential for harm due to the excessive administration of IVFs to patients with septic shock.