Review Article

Fluid Resuscitation in Sepsis: Reexamining the Paradigm

Table 1

Summary of studies evaluating crystalloids.

AuthorYearStudy designSample sizeStudy fluidPrimary endpointComments

Wilcox [45]1983Animal experiment48Chloride rich solutionsRegulation of renal blood flowIncreased renal vasoconstriction and GFRa with chloride rich solutions

Waters et al. [49]2001Prospective randomized study660.9% Saline versus lactated RingerMultiple outcomes studiedIncreased use of blood products and acidosis with 0.9% Saline

O’Malley et al. [50]2005Randomised clinical trial510.9% Saline versus lactated RingerCreatinine concentration on POD3bNo difference; but Ringer’s was associated with less hyperkalemia and acidosis

Shaw et al. [51]2012Observational31,9200.9% Saline versus balanced crystalloidMajor morbidityHigher mortality, increased transfusion requirements, dialysis requirements, and increased buffer requirements in saline group

Maitland et al. [52]2011Multicentric randomized trial3141Albumin bolus and saline bolusMortalityBoluses resulted in increased mortality

Table summarizing studies evaluating crystalloids. aGlomerular Filtration Rate, bPostoperative Day 3.