IVF in sepsis

Q: In early management of sepsis, intravenous fluids (IVF) should be given at 30 mL/kg per? (select one)

A) actual body weight

B) ideal body weight

Answer: A

Beside other aspects of management in early sepsis like antibiotics and achieving control over ABC i.e., Airway, Breathing and Circulation - the most profound management is to achieve and/or preserve tissue perfusion. It is mostly achieved by the aggressive administration of intravenous fluids (IVF). The fluid recommended is either any balanced crystalloid or normal saline at 30 mL/kg. This should be given by actual body weight. 

Per guidelines, IVF should be started within one hour and completed within the first three hours following the presentation.

#hemodynamics

#sepsis

References:

1. Macdonald S. Fluid Resuscitation in Patients Presenting with Sepsis: Current Insights. Open Access Emerg Med. 2022 Nov 29;14:633-638. doi: 10.2147/OAEM.S363520. PMID: 36471825; PMCID: PMC9719278.

2. Zampieri FG, Bagshaw SM, Semler MW. Fluid Therapy for Critically Ill Adults With Sepsis: A Review. JAMA. 2023 Jun 13;329(22):1967-1980. doi: 10.1001/jama.2023.7560. PMID: 37314271.

3. Brown RM, Semler MW. Fluid Management in Sepsis. J Intensive Care Med. 2019 May;34(5):364-373. doi: 10.1177/0885066618784861. Epub 2018 Jul 9. PMID: 29986619; PMCID: PMC6532631.