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There are several small and large animal models that demonstrate improvements in mortality with fluid resuscitation.
The highest severity group exhibited no change in actual or expected mortality with fluid administration.
This group of patients has significant morbidity and mortality with fluid overload and changes in renal function.
Similar(57)
Recent research has identified an increased rate of mortality associated with fluid bolus therapy for severe sepsis and septic shock, but the mechanisms are still not well understood.
Carcillo and colleagues [ 6] reported a decade ago that paediatric patients in septic shock had reduced mortality with rapid fluid administration, initially with crystalloids but with one-third of the total fluid given as colloid.
A trend towards improved mortality with less fluid was observed but not statistically significant.
Similarly, other studies have reported higher rates of morbidity and mortality with positive fluid balance in septic shock [83 89] and one retrospective pilot study reported good prognosis in patients who achieved a negative fluid balance within the first 3 days of septic shock [90].
Although some authors have reported that increased fluid intake can decrease mortality [ 27], others have failed in their attempts to correct the initial hypovolemia and morbidity and mortality with increased fluid intake [ 14, 15].
The ability of AVP and terlipressin to reduce mortality when compared with fluid resuscitation therapy, other vasopressors (norepinephrine or epinephrine), or placebo was investigated.
A secondary multiple regression analysis was repeated for hospital mortality, with mean daily fluid balance included after initial analysis suggested a strong fluid balance-related effect.
As a result of the study, type 2 fluid status was associated with much higher BNP levels than type 3 fluid status 591 (203 to 1,949) versus 61 (51 to 65) pmol/L but conferring a similar mortality with type 3 fluid status.
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