No fewer deaths seen with restricted IV fluid for septic shock
For adults in the intensive care unit (ICU) with septic shock, intravenous fluid restriction does not result in fewer deaths at 90 days than standard intravenous fluid therapy, according to a study published online June 17 in the New England Journal of Medicine to coincide with the annual Critical Care Reviews Meeting, held from June 15 to 17 in Belfast.
Tine S. Meyhoff, M.D., from Copenhagen University Hospital-Rigshospitalet in Denmark, and colleagues conducted an international, randomized trial involving 1,554 patients with septic shock in the ICU who were randomly assigned to receive either restricted intravenous fluid or standard intravenous fluid therapy (770 and 784 patients, respectively).
Participants in the restrictive fluid group received a median of 1,798 mL of intravenous fluid compared with a median of 3,811 mL in the standard fluid group. The researchers found that death occurred in 42.3 and 42.1 percent of participants in the restrictive-fluid group and standard-fluid group, respectively, at 90 days. In the ICU, serious adverse events occurred at least once in 29.4 and 30.8 percent of patients in the restrictive-fluid and standard-fluid groups, respectively. At 90 days after randomization, the two groups had similar numbers of days alive without life support and days alive and out of the hospital.
"We observed no significant differences in 90-day mortality or serious adverse events among the patients who received restricted fluid therapy and those who received standard therapy," the authors write.
The study was funded by a grant from the Novo Nordisk Foundation.
Lauralyn A. McIntyre et al, Intravenous Fluids in Septic Shock—More or Less?, New England Journal of Medicine (2022). DOI: 10.1056/NEJMe2206160
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