Yi-Chun Gong,Jing-Tao Liu,Peng-Lin Ma.[J].Chin J Traumatol,2018,21(1):1-3. [doi]
Early fluid loading for septic patients: Any safety limit needed?
  
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KeyWord: Sepsis Fluid loading Hemodynamic stability Safety
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Author NameAffiliation
Yi-Chun Gong SICU, The 309th Hospital of Chinese People's Liberation Army, Beijing 100091, China 
Jing-Tao Liu SICU, The 309th Hospital of Chinese People's Liberation Army, Beijing 100091, China 
Peng-Lin Ma SICU, The 309th Hospital of Chinese People's Liberation Army, Beijing 100091, China 
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Abstract:
      Early adequate fluid loading was the corner stone of hemodynamic optimization for sepsis and septic shock. Meanwhile, recent recommended protocol for fluid resuscitation was increasingly debated on hemodynamic stability vs risk of overloading. In recent publications, it was found that a priority was often given to hemodynamic stability rather than organ function alternation in the early fluid resuscitation of sepsis. However, no safety limits were used at all in most of these reports. In this article, the rationality and safety of early aggressive fluid loading for septic patients were discussed. It was concluded that early aggressive fluid loading improved hemodynamics transitorily, but was probably traded off with a follow-up organ function impairment, such as worsening oxygenation by reduction of lung aeration, in a part of septic patients at least. Thus, a safeguard is needed against unnecessary excessive fluids in early aggressive fluid loading for septic patients.
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