Fluid resuscitation targeting sepsis-induced cardiovascular dysfunction: severity of disease as effect modifier

Fluid resuscitation is the cornerstone of resuscitation in patients with sepsis and septic shock. According to a recent retrospective cohort study of patients with a diagnosis of sepsis, respiratory events, among others, were the strongest predictors of mortality in hospitalized patients (1). Preventing development of nosocomial adult respiratory distress syndrome (ARDS) can contribute to improving survival in this cohort of patients (2). Strategies hereto comprise, apart from hemodynamic resuscitation for sepsis, prophylactic treatment of ARDS with appropriate medications and timely antimicrobials. Furthermore, restrictive transfusion practices help avoid transfusion-related adverse events, and precautionary measures must be in place to prevent aspiration. Adhering to sepsis guidelines has resulted in lowering morbidity and mortality rates, but they continue to be high (3). To reduce shock duration and associated poor survival in sepsis, prompt and adequate fluid resuscitation is recommended (4)