Prompt

Septic shock in ED: which fluid, how much, how do you know more fluid will help, and which fluids are forbidden?

Interpretation

Reveal interpretationShow

Balanced crystalloid default (SMART). Aliquoted boluses; test responsiveness with PLR. HES abandoned (AKI). Albumin harmful in TBI. Early vasopressors if non-responsive or profound vasoplegia. Trauma bleeding: blood products, not crystalloid flood.^[1]^[2]^[3]

References3Show

[1]Semler MW, Self WH, Rice TW Balanced crystalloids versus saline in critically ill adults (SMART). New England Journal of Medicine, 2018.PMID 29768150
[2]Myburgh J, Cooper DJ, Finfer S, et al. Saline or albumin for fluid resuscitation in patients with traumatic brain injury. New England Journal of Medicine, 2007.PMID 17761591
[3]Myburgh JA, Finfer S, Bellomo R, et al. Hydroxyethyl starch or saline for fluid resuscitation in intensive care (CHEST). New England Journal of Medicine, 2012.PMID 23075127

Prompt

Septic shock in ED: which fluid, how much, how do you know more fluid will help, and which fluids are forbidden?

Interpretation

Reveal interpretationShow

References3Show

[1]Semler MW, Self WH, Rice TW Balanced crystalloids versus saline in critically ill adults (SMART). New England Journal of Medicine, 2018.PMID 29768150
[2]Myburgh J, Cooper DJ, Finfer S, et al. Saline or albumin for fluid resuscitation in patients with traumatic brain injury. New England Journal of Medicine, 2007.PMID 17761591
[3]Myburgh JA, Finfer S, Bellomo R, et al. Hydroxyethyl starch or saline for fluid resuscitation in intensive care (CHEST). New England Journal of Medicine, 2012.PMID 23075127

Fluid resuscitation — SMART, PLR and colloid traps

Interpretation

Fluid resuscitation — SMART, PLR and colloid traps

Interpretation