Initial fluid resuscitation of patients with septic shock in the intensive care unit.


BACKGROUND:Fluid is the mainstay of resuscitation of patients with septic shock, but the optimal composition and volume are unknown. Our aim was to evaluate the current initial fluid resuscitation practice in patients with septic shock in the intensive care unit (ICU) and patient characteristics and outcome associated with fluid volume. METHODS:This was a prospective, cohort study of all patients with septic shock (n=132) admitted in six ICUs during a 3-month period. Patients were divided into two groups according to the overall median volume of resuscitation fluid administered during the first 24 h after the diagnosis. Baseline characteristics, other treatments, monitoring and outcome were compared between the groups. RESULTS:The mean volume of resuscitation fluid was 4.9 l (median 4.0 l and SD 3.5). Patients in the higher volume group received more crystalloids (3.7 vs. 1.2 l, P<0.0001), colloids (1.8 vs. 0.9 l, P<0.0001), blood products (1.8 vs. 0.6 l, P=0.0004), a higher maximum vasopressor dose (0.37 vs. 0.21 μg/kg/min, P<0.0001) and had a higher initial plasma concentration of lactate (4.0 vs. 3.0 mM, P=0.009) compared with the lower volume group. Simplified acute physiology score II in the lower and higher dose group were 52 and 58 (P=0.07). There were no differences in 30-, 90- or 365-day mortality between the two fluid volume groups. CONCLUSION:In the ICU, patients with septic shock were resuscitated with a combination of crystalloids, colloids and blood products. Although the more severely shocked patients received higher volumes of crystalloids, colloids and blood products, mortality did not differ between the groups.


Carlsen S,Perner A,East Danish Septic Shock Cohort Investigators.




Has Abstract


2011-04-01 00:00:00












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    abstract:BACKGROUND:Patient-controlled epidural analgesia, PCEA, has been introduced in obstetric analgesia during the past decade. Many studies have shown that the consumption of analgesic is reduced when the parturient requests her own doses. This study investigates whether this is also true when using an ultra-low-dose regim...

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    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Ledin Eriksson S,Gentele C,Olofsson CH

    更新日期:2003-10-01 00:00:00

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    abstract::An important element of how adverse events are handled is effective communication between health care providers and patients and their families. This review addresses the main questions: What do patients expect in the aftermath of an adverse event? What is known about the practice of open disclosure? How can organizat...

    journal_title:Acta anaesthesiologica Scandinavica

    pub_type: 杂志文章,评审


    authors: Manser T,Staender S

    更新日期:2005-07-01 00:00:00

  • The interaction of temperature with thiopental and etomidate on extracellular dopamine and glutamate levels in Wistar-Kyoto rats subjected to forebrain ischemia.

    abstract:BACKGROUND:Many studies demonstrate an association between brain damage and the extracellular release of catecholamines and amino acids during cerebral ischemia. While the clinical value of hypothermia during periods of compromised cerebral blood flow and oxygen delivery is well established, the role of anesthetic agen...

    journal_title:Acta anaesthesiologica Scandinavica

    pub_type: 杂志文章


    authors: Lesser JB,Koorn R,Vloka JD,Kuroda MM,Thys DM

    更新日期:1999-11-01 00:00:00

  • Cognitive function in patients with chronic pain treated with opioids: characteristics and associated factors.

    abstract:BACKGROUND:The paucity of studies regarding cognitive function in patients with chronic pain, and growing evidence regarding the cognitive effects of pain and opioids on cognitive function prompted us to assess cognition via neuropsychological measurement in patients with chronic non-cancer pain treated with opioids. ...

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    authors: Kurita GP,de Mattos Pimenta CA,Braga PE,Frich L,Jørgensen MM,Nielsen PR,Højsted J,Sjøgren P

    更新日期:2012-11-01 00:00:00

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    abstract::The plasma fluoride and bromide concentrations were studied in operating theatre personnel. When enflurane was used, the increase in plasma fluoride concentration could not be distinguished from normal individual variations, but the plasma bromide concentration increased significantly when halothane was used. Seven pa...

    journal_title:Acta anaesthesiologica Scandinavica

    pub_type: 杂志文章


    authors: Carlsson P,Ekstrand J,Hallén B

    更新日期:1985-10-01 00:00:00

  • Out-of-hours intensive care unit admission and 90-day mortality: a Danish nationwide cohort study.

    abstract:BACKGROUND:Mortality rates in critically ill adult patients admitted to the intensive care unit (ICU) remains high, and numerous patient- and disease-related adverse prognostic factors have been identified. In recent years, studies in a variety of emergency conditions suggested that outcome is dependent on the time of ...

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    authors: Buck DL,Christiansen CF,Christensen S,Møller MH,Danish Intensive Care Database.

    更新日期:2018-08-01 00:00:00

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    journal_title:Acta anaesthesiologica Scandinavica

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    authors: Bjørnholdt KT,Mønsted PN,Søballe K,Nikolajsen L

    更新日期:2014-07-01 00:00:00

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    abstract::Interleukin-6 (IL-6), a cytokine involved in the pathogenesis of sepsis and septic shock, and lymphocyte subpopulations were measured in blood circulation of patients receiving sodium nitroprusside (SNP) for induction of hypotension. The aim of this study was to evaluate whether this procedure influences distribution ...

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    abstract:BACKGROUND:Patient-controlled epidural analgesia (PCEA) with a moderate to high concentration of bupivacaine in obstetrics has been shown to give comparable analgesia and even higher level of satisfaction compared to continuous epidural infusion. We hypothesised that the use of a very low concentration technique (ropiv...

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    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Smedvig JP,Soreide E,Gjessing L

    更新日期:2001-05-01 00:00:00

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    journal_title:Acta anaesthesiologica Scandinavica

    pub_type: 杂志文章


    authors: Buckenmaier CC 3rd,Steele SM,Nielsen KC,Martin AH,Klein SM

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    pub_type: 杂志文章,多中心研究


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    更新日期:2018-02-01 00:00:00

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    journal_title:Acta anaesthesiologica Scandinavica

    pub_type: 杂志文章


    authors: Olsson GL,Hallén B

    更新日期:1988-11-01 00:00:00

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    abstract:BACKGROUND:Postoperative cognitive dysfunction (POCD) is a common complication, especially in the elderly. The aim of this study was to describe how variability in neuropsychological testing could lead to the detection of cognitive improvement and poor consistency of POCD between postoperative test sessions. METHODS:I...

    journal_title:Acta anaesthesiologica Scandinavica

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    authors: Rasmussen LS,Siersma VD,ISPOCD GROUP.

    更新日期:2004-10-01 00:00:00

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    abstract:BACKGROUND:Although buprenorphine sometimes causes severe emesis, its relation to the menstrual cycle has not been reported. METHODS:We conducted a prospective study on 68 reproductive-age women following lower extremity surgery under epidural anesthesia plus buprenorphine, to assess the effect of the day of the menst...

    journal_title:Acta anaesthesiologica Scandinavica

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    authors: Kitamura A,Kon T,Kamiyama M,Ogawa R

    更新日期:1996-03-01 00:00:00

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    abstract:BACKGROUND:Recently, clinical reports have suggested a relationship between the occurrence of hyperalgesia, allodynia and/or myoclonus and treatment with high doses of morphine in humans. Although few clinical descriptions of these phenomena are available, experimental work supports the notion that high doses of morphi...

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    authors: Sjøgren P,Thunedborg LP,Christrup L,Hansen SH,Franks J

    更新日期:1998-10-01 00:00:00

  • Wireless high-frequency dorsal root ganglion stimulation for chronic low back pain: A pilot study.

    abstract:OBJECTIVE:Evaluation of the efficacy of a wireless high-frequency stimulator placed over selected DRG of exiting nerve roots for the treatment of chronic low back pain. DESIGN:Feasibility. SUBJECTS:Six subjects with chronic, intractable back pain refractory to standard medical treatment. METHODS:Four stimulators (Fr...

    journal_title:Acta anaesthesiologica Scandinavica

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    authors: Billet B,Hanssens K,De Coster O,Nagels W,Weiner RL,Wynendaele R,Vanquathem N

    更新日期:2018-04-19 00:00:00

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    abstract::Regional anaesthesia has many advantages over general anaesthesia in hip surgery. When the effects of total hip replacement under spinal or general anaesthesia were compared in 22 patients, the only difference between the groups occurred in PHA-induced lymphocyte proliferative responses. In contrast, no differences be...

    journal_title:Acta anaesthesiologica Scandinavica

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    authors: Salo M,Nissilä M

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    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Linnemann MU,Guldager H,Nielsen J,Ibsen M,Hansen RW

    更新日期:1993-01-01 00:00:00

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    abstract::The effects of droperidol on the systemic vascular resistance (SVR) and the venous capacitance were studied during cardiopulmonary bypass (CPB) in 24 patients. CPB was performed with either pulsatile or non-pulsatile flow. During non-pulsatile flow, droperidol (0.15 mg X kg-1 and 0.30 mg X kg-1) decreased SVR and incr...

    journal_title:Acta anaesthesiologica Scandinavica

    pub_type: 杂志文章


    authors: Videcoq M,Desmonts JM,Marty J,Hazebroucq J,Langlois J

    更新日期:1987-07-01 00:00:00

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    pub_type: 杂志文章


    authors: DE Mos M,Huygen FJ,VAN DER Hoeven-Borgman M,Dieleman JP,Stricker BH,Sturkenboom MC

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    pub_type: 杂志文章


    authors: Zarén B,Bergström R

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    abstract:BACKGROUND:Short-term infusion of atrial natriuretic peptide (ANP) increases renal blood flow (RBF) and glomerular filtration rate (GFR) in patients with acute renal dysfunction. In the present study we evaluated the effects of long-term infusion (>48 h) of ANP on (RBF) and (GFR) in 11 postcardiac surgical patients req...

    journal_title:Acta anaesthesiologica Scandinavica

    pub_type: 临床试验,杂志文章


    authors: Swärd K,Valson F,Ricksten SE

    更新日期:2001-05-01 00:00:00

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    journal_title:Acta anaesthesiologica Scandinavica

    pub_type: 杂志文章


    authors: Maarslet L,Møller MB,Dall R,Hjortholm K,Ravn H

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    journal_title:Acta anaesthesiologica Scandinavica

    pub_type: 杂志文章


    authors: Roscher R,Ingemansson R,Algotsson L,Sjöberg T,Steen S

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    journal_title:Acta anaesthesiologica Scandinavica

    pub_type: 临床试验,杂志文章


    authors: Puntervoll SA,Søreide E,Jacewicz W,Bjelland E

    更新日期:2002-04-01 00:00:00

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    journal_title:Acta anaesthesiologica Scandinavica

    pub_type: 杂志文章


    authors: Grace D,Milligan KR,Loughran PG,McCaughey W

    更新日期:1994-05-01 00:00:00

  • Changes in the T-wave amplitude of ECG during isoflurane anaesthesia.

    abstract::R/T-wave amplitude ratio of electrocardiogram (ECG), heart rate (HR) and systolic arterial pressure (SAP) were recorded in 15 patients awake, at 1 minimal alveolar concentration of isoflurane before and during surgery, and in deep anaesthesia (electroencephalogram burst suppression) during surgery. R/T-wave amplitude ...

    journal_title:Acta anaesthesiologica Scandinavica

    pub_type: 杂志文章


    authors: Annila P,Jäntti V,Lindgren L,Yli-Hankala A

    更新日期:1993-08-01 00:00:00

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    journal_title:Acta anaesthesiologica Scandinavica

    pub_type: 杂志文章


    authors: Linko K,Saxelin I

    更新日期:1986-02-01 00:00:00

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    journal_title:Acta anaesthesiologica Scandinavica

    pub_type: 杂志文章,随机对照试验


    authors: Shim YH,Kweon TD,Lee JH,Nam SB,Kwak YL

    更新日期:2006-09-01 00:00:00

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    journal_title:Acta anaesthesiologica Scandinavica

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Viitanen H,Baer G,Annila P

    更新日期:2000-01-01 00:00:00