Totem and taboo: fluids in sepsis

The need for early, rapid, and substantial fluid resuscitation in septic patients has long been an article of faith in the intensive care community, a tribal totem that is taboo to question. The results of a recent multicenter trial in septic children in Africa, published in The New England Journal...

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Bibliographic Details
Published in:Critical care (London, England) England), 2011-01, Vol.15 (3), p.164-164
Main Authors: Hilton, Andrew K, Bellomo, Rinaldo
Format: Article
Language:English
Subjects:
Africa - epidemiology
Animals
Child
Clinical Trials as Topic - trends
Critical Illness - epidemiology
Fluid Therapy - methods
Humans
Multicenter Studies as Topic - trends
Sepsis - epidemiology
Sepsis - therapy
Taboo
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Summary:The need for early, rapid, and substantial fluid resuscitation in septic patients has long been an article of faith in the intensive care community, a tribal totem that is taboo to question. The results of a recent multicenter trial in septic children in Africa, published in The New England Journal of Medicine, powerfully challenge the fluid paradigm. The salient aspects of the trial need to be understood and reflected upon. In this commentary, we discuss the background to and findings of the trial and explain why they will likely trigger a re-evaluation of our thinking about fluids in sepsis, a re-evaluation that is already happening in the treatment of acute respiratory distress syndrome and acute kidney injury and in postoperative care.
ISSN:1364-8535
1466-609X
DOI:10.1186/cc10247