Pre-operative fluid resuscitation in the emergency general surgery septic patient: does it really matter?

Emergency general surgery (EGS) patients presenting with sepsis remain a challenge. The Surviving Sepsis Campaign recommends a 30 mL/kg fluid bolus in these patients, but recent studies suggest an association between large volume crystalloid resuscitation and increased mortality. The optimal amount...

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Bibliographic Details
Published in:BMC emergency medicine 2021-07, Vol.21 (1), p.86-86, Article 86
Main Authors: Moran, Benjamin, Major, Erin, Kufera, Joseph A, Tisherman, Samuel A, Diaz, Jose
Format: Article
Language:English
Subjects:
Abdominal Sepsis
Adult
Age
Aged
Creatinine
Crystalloid Solutions
Emergencies
Emergency general surgery
Emergency medical care
Female
Fluid resuscitation
Fluid Therapy
General Surgery
Heart rate
Hemodynamics
Hemorrhage
Humans
Intensive care
Intensive Care Units
Length of stay
Male
Middle Aged
Mortality
Patients
Pre-operative resuscitation
Resuscitation
Retrospective Studies
Sepsis
Sepsis - surgery
Sepsis - therapy
Source control
Surgery
Ventilators
Vital signs
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Summary:Emergency general surgery (EGS) patients presenting with sepsis remain a challenge. The Surviving Sepsis Campaign recommends a 30 mL/kg fluid bolus in these patients, but recent studies suggest an association between large volume crystalloid resuscitation and increased mortality. The optimal amount of pre-operative fluid resuscitation prior to source control in patients with intra-abdominal sepsis is unknown. This study aims to determine if increasing volume of resuscitation prior to surgical source control is associated with worsening outcomes. We conducted an 8-year retrospective chart review of EGS patients undergoing surgery for abdominal sepsis within 24 h of admission. Patients in hemorrhagic shock and those with outside hospital index surgeries were excluded. We grouped patients by increasing pre-operative resuscitation volume in 10 ml/kg intervals up to > 70 ml/kg and later grouped them into
ISSN:1471-227X
1471-227X
DOI:10.1186/s12873-021-00479-3