Similarly, the Surviving Sepsis Campaign International guidelines do not recommend the use of HES for fluid resuscitation
in patients with sepsis (Figure 2) (1).
Controlled blood pressure elevation and limited fluid resuscitation
method have been gradually popularized in the rescue of patients with multi-injury induced shock in Intensive Care Unit (ICU).6 Limited fluid resuscitation
refers to keeping blood pressure of hemorrhagic shock patients with uncontrolled bleeding within a range which can satisfy the demand of organs on the lowest perfusion but will not cause excessive disturbances to the internal environment and compensatory mechanism by controlling the input quantity and speed of liquid.7,8 Fan et al.
Once all targets have been met, and the destination has been achieved, proceed to negative fluid resuscitation
as soon as possible.
The primary goal in fluid resuscitation
in paediatric population is to maintain urine output of greater than 1ml/kg/hour assessed by catheterizing the patients.
The proposed mechanism for the development of ODS varied among the cases but overall included severe acidosis (pH < 7.0), aggressive fluid resuscitation
, hyperosmolar therapy, bacteremia with possible meningitis, and wide fluctuations in glucose, sodium, or osmolarity.
Bracht et al., "Effect of fluid resuscitation
on mortality and organ function in experimental sepsis models," Critical Care, vol.
Bartel et al., "Early fluid resuscitation
reduces morbidity among patients with acute pancreatitis," Clinical Gastroenterology and Hepatology, vol.
He was commenced on IV fluid resuscitation
and broad spectrum IV antibiotics (ceftriaxone and metronidazole) and was worked up for surgery.
 This variation may be due to the fact that most of the cases in our study were dengue shock syndrome with encephalitis, and the initial circulatory instability was corrected promptly with fluid resuscitation
. Apart from this most of the cases with poor pulse at '0' hour died before 48 hours.
Clinicians supporting this hypothesis suggest to cautiously administer fluid resuscitation
with the aim of maintaining a subnormal blood pressure (systolic of 70-90 mmHg), whilst allowing sufficient oxygen delivery.
From intraoperative TEE findings, we found that postresection hypotension is almost always associated with hypovolemia from chronic catecholamine secretion and should be treated by aggressive fluid resuscitation
. Serial neurological and cardiac evaluations should be considered as part of management in a patient with severe intraoperative hypertension or hypotension.
Severe sepsis is defined as sepsis plus sepsis-induced organ dysfunction or tissue hypoperfusion, while septic shock is defined as sepsis-induced hypotension persisting despite adequate fluid resuscitation