New sepsis definitions and the role of fluid resuscitation

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Measures such as blood pressure and central venous pressure are not reliable. Fluid challenges and responsiveness should be based on stroke volume change of greater than 10%” Seckel and Ahrens (2016).

Abstract:

There are two important recent changes in sepsis care. The first key change is the 2016 Sepsis-3 definitions from the recent consensus workgroup with new sepsis and septic shock definitions. Useful tools for assessing patients that have a greater risk of mortality include Sequential Organ Failure Assessment (SOFA) in intensive care units and quick SOFA outside intensive care units. The second change involves management of fluid resuscitation and measures of volume responsiveness. Measures such as blood pressure and central venous pressure are not reliable. Fluid challenges and responsiveness should be based on stroke volume change of greater than 10%.

Reference:

Seckel, M.A. and Ahrens, T. (2016) Challenges in Sepsis Care: New Sepsis Definitions and Fluid Resuscitation Beyond the Central Venous Pressure. Critical Care Nursing Clinics of North America. 28(4), p.513-532.

doi: 10.1016/j.cnc.2016.08.001.

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