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TITLE:

ROLE OF FLUID RESUSCITATION IN THE MANAGEMENT OF SEPSIS AND SEPTIC SHOCK

AUTHORS:

Hamad Ahmad, FNU Neelma, Salman Haider, Ishtiaq Ahmad

ABSTRACT:

Sepsis is a systemic inflammatory response to severe infection that may cause significant morbidity and mortality and is one of the most common conditions in the patients admitted to the Intensive Care Unit. This article focuses on the role of fluid therapy and the outcomes of different approaches towards fluid administration in patients with sepsis and septic shock. In the era of modern medical science, management of sepsis has always been a major challenge and that is why the development of sepsis in critically ill patients is always considered a bad prognostic indicator. Antibiotics and fluids resuscitation are the fundamentals in the management of sepsis. The sensitivity of the bugs causing sepsis determines the choice of the antibiotics but fluid resuscitation can be challenging at times. Crystalloids are considered the fluids of the first choice in patients with sepsis. Different compositions of the intravenous fluids have different effects on the organs, hence care must be taken while choosing a specific type of fluid for treating a patient with sepsis. The risk of kidney injury and death appears to be greater with semi-synthetic colloids than with crystalloids The quantity of fluid administered places a pivotal role in the outcome of patients with sepsis. We have found in our review that excess fluid administration can be harmful at times and may even worsen the shock while a more restrictive and individualized approach to fluid resuscitation may demonstrate improved outcomes. Hence, we suggest that the type of fluid administered and the quantity should be tailored through an individualized and physiologic approach to decrease the morbidity and mortality associated with sepsis.

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