Expert statement for the management of hypovolemia in sepsis

Anders Perner; Maurizio Cecconi; Maria Cronhjort; Michael Darmon; Stephan M Jakob; Ville Pettilä; Iwan C C van der Horst

doi:10.1007/s00134-018-5177-x

Expert statement for the management of hypovolemia in sepsis

Intensive Care Med. 2018 Jun;44(6):791-798. doi: 10.1007/s00134-018-5177-x. Epub 2018 Apr 25.

Authors

Anders Perner¹, Maurizio Cecconi², Maria Cronhjort³, Michael Darmon^{4

5

6}, Stephan M Jakob⁷, Ville Pettilä⁸, Iwan C C van der Horst⁹

Affiliations

¹ Department of Intensive Care, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark. anders.perner@regionh.dk.
² Department Anaesthesia and Intensive Care Units, IRCCS Istituto Clinico Humanitas, Humanitas University, Milan, Italy.
³ Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
⁴ Medical ICU, Saint-Louis University Hospital, AP-HP, Paris, France.
⁵ ECSTRA Team, Biostatistics and Clinical Epidemiology, UMR 1153 (Center of Epidemiology and Biostatistic Sorbonne Paris Cité, CRESS), INSERM, Paris, France.
⁶ Paris-7 Medical School, Université Paris-Diderot, Sorbonne-Paris-Cité, Paris, France.
⁷ Department of Intensive Care Medicine, University Hospital Bern (Inselspital), University of Bern, Bern, Switzerland.
⁸ Department of Anesthesiology, Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
⁹ Department of Critical Care, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.

PMID: 29696295
DOI: 10.1007/s00134-018-5177-x

Abstract

Hypovolemia is frequent in patients with sepsis and may contribute to worse outcome. The management of these patients is impeded by the low quality of the evidence for many of the specific components of the care. In this paper, we discuss recent advances and controversies in this field and give expert statements for the management of hypovolemia in patients with sepsis including triggers and targets for fluid therapy and volumes and types of fluid to be given. Finally, we point to unanswered questions and suggest a roadmap for future research.

Keywords: Critical care; Fluid therapy; Hemodynamics; Hypovolemia; Sepsis; Shock.

Publication types

Review

MeSH terms

Fluid Therapy*
Humans
Hypovolemia* / complications
Hypovolemia* / therapy
Sepsis* / complications