AggiornAmenti in riAnimAzione e terApiA intensivA - Pacini Editore

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Fluid therapy in septic shock
E.P. Rivers
A.K. Jaehne
L. Eichhorn-Wharry
S. Brown
D. Amponsah
Department of Emergency
Medicine, Henry Ford
Hospital, Wayne State
University, Detroit, Michigan,
USA
PURPOSE Of REvIEw: To examine the role of fluid therapy in the pathogenesis
of severe sepsis and septic shock. The type, composition, titration,
management strategies and complications of fluid administration will be
examined in respect to outcomes.
RECEnT fIndInGS: Fluids have a critical role in the pathogenesis and treatment
of early resuscitation of severe sepsis and septic shock.
SUMMARy: Although this pathogenesis is evolving, early titrated fluid administration
modulates inflammation, improves microvascular perfusion,
impacts organ function and outcome. Fluid administration has limited impact
on tissue perfusion during the later stages of sepsis and excess fluid
is deleterious to outcome. The type of fluid solution does not seem to
influence these observations.
Curr Opin Crit Care 2010;16(4):297-308