Hemodynamic resuscitation for septic shock

"Intravenous fluids and vasoactive medications represent the foundation of hemodynamic resuscitation for septic shock. Based on current evidence, initial fluid resuscitation of roughly 30 mL/kg with balanced crystalloids is reasonable for most patients" Graham et al (2026).

"Intravenous fluids and vasoactive medications represent the foundation of hemodynamic resuscitation for septic shock. Based on current evidence, initial fluid resuscitation of roughly 30 mL/kg with balanced crystalloids is reasonable for most patients" Graham et al (2026).

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Hemodynamic resuscitation for septic shock

Abstract:

Intravenous fluids and vasoactive medications represent the foundation of hemodynamic resuscitation for septic shock. Based on current evidence, initial fluid resuscitation of roughly 30 mL/kg with balanced crystalloids is reasonable for most patients. Carefully monitored peripheral vein administration of the first-line vasopressor, norepinephrine, appears safe. Ongoing multimodal assessment and therapy titration integrating blood pressure, lactate clearance, capillary refill time, and dynamic measures of fluid responsiveness yields outcomes equivalent to protocolized goal-directed resuscitation. However, better evidence is urgently needed for many common septic shock management issues.

Reference:

Graham JD, Lanspa MJ, Peltan ID. Resuscitation Targets, Fluids, and Vasoactives in Septic Shock. Clin Chest Med. 2026 Mar;47(1):33-43. doi: 10.1016/j.ccm.2025.10.003. Epub 2025 Nov 27. PMID: 41651598.