Please use this identifier to cite or link to this item: https://www.arca.fiocruz.br/handle/icict/30451
Title: Early fluid resuscitation in sepsis: evidence and perspectives
Authors: Bozza, Fernando A.
Carnevale, Renata
Japiassú, André Miguel
FariaNeto, Hugo Caire Castro
Angus, Derek C.
Salluh, Jorge I. F.
Affilliation: Fundação Oswaldo Cruz. Instituto de Pesquisa Clínica Evandro Chagas. Unidade de Cuidados Intensivos. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Imunofarmacologia. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto de Pesquisa Clínica Evandro Chagas. Unidade de Cuidados Intensivos. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Imunofarmacologia. Rio de Janeiro, RJ, Brasil.
University of Pittsburgh. Department od Clinical Care Medicine. Pittsburg, Pennsylvania, USA.
Instituto Nacional de Câncer. Unidade de Cuidados Intensivos. Rio de Janeiro, RJ, Brasil.
Abstract: Hemodynamic instability plays a major role in the pathogenesis of systemic inflammation, tissue hypoxia, and multiple organ dysfunction in sepsis. Aggressive fluid replacement is one of the key interventions for the hemodynamic support in severe sepsis. In this scenario, the ability to restore the imbalance between tissue oxygen demand and supply, the heterogeneity in microcirculation, and endothelial dysfunction in the early stages of sepsis are associated with reduced mortality. In 2001, a single-center randomized controlled trial showed impressive reductions in hospital mortality when patients presenting to the emergency department with severe sepsis were treated with an aggressive protocol of fluids, blood transfusion, and inotropes aiming to improve tissue perfusion. However, external validation of this trial remains to be carried out. To date, there is no unequivocal evidence that such strategy is both universally feasible and effective. In the present article, we review the current evidence and comment on the future perspectives on early fluid resuscitation in severe sepsis.
Keywords: Sepsis
Surviving Sepsis Campaign
hemodynamic optimization
shock
fluid replacement
early goaldirected therapy
keywords: Sepse
Choque
reposição de fluidos
Campanha Sobrevivendo à Sepse
otimização hemodinâmica
terapia direcionada precoce
Issue Date: 2010
Publisher: Lippincott, Williams & Wilkins
Citation: BOZZA, Fernando A.; et al. Early fluid resuscitation in sepsis: evidence and perspectives. Shock, v.34, Supl. 1, p.40-43, 2010.
DOI: 10.1097/SHK.0b013e3181e7e668
ISSN: 1073-2322
Copyright: restricted access
Appears in Collections:IOC - Artigos de Periódicos

Files in This Item:
File Description SizeFormat 
renata_carnevale_etal_IOC_2010.pdf282.84 kBAdobe PDF    Request a copy


FacebookTwitterDeliciousLinkedInGoogle BookmarksBibTex Format mendeley Endnote DiggMySpace

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.