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Exact(6)
These findings do not support the systematic use of EGDT, of which more aggressive fluid resuscitation is a component, in the management of patients with septic shock.
One conclusion might be that TPTD results in more aggressive fluid infusion, which could be detrimental.
Since shock was more frequently present in patients with low [BE], these patients received more aggressive fluid resuscitation before ICU admission.
The perception of a greater ability to predict fluid responsiveness [ 6- 10] once PiCCO was applied might have induced a greater number of fluid challenges or more aggressive fluid challenges.
A high caval index of > 36.5% has a low positive predictive value for fluid responsiveness after a 500 ml fluid challenge, which might reflect the need for more aggressive fluid resuscitation.
Fifth, we did not control the effect of fluid management, which has been shown to influence Ang-2 levels [ 8], so that it is not possible to exclude the idea that more aggressive fluid therapy could have resulted in higher Ang-2 levels in some patients.
Similar(54)
Although the initial physiological status (except for heart rate) and GCS score were similar in the two groups, patients with whole-body CT had benefited from a more aggressive management (fluid loading, intubation, and catecholamine administration) in the pre-hospital phase or at admission.
In that circumstance, more aggressive removal of fluid can lead to acute kidney failure.
Langer and coworkers suggested a more aggressive treatment of perinephric fluid collections and lymphoceles in patients treated with the association SRL-CsA-Pred [ 42].
Perhaps, nursing home residents were treated with more aggressive antibiotics and more frequent fluid boluses than their non-nursing home counterparts, thus eliminating any higher likelihood of disease progression that would otherwise exist in that patient subgroup.
The success of endoscopic intervention in the management of uncomplicated pancreatic pseudocysts has allowed endoscopists to be more aggressive in managing complicated pancreatic fluid collections.
Related(13)
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Justyna Jupowicz-Kozak
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