Pfortmueller, Carmen Andrea; Dabrowski, Wojciech; Wise, Rob; van Regenmortel, Niels; Malbrain, Manu L N G (2024). Fluid accumulation syndrome in sepsis and septic shock: pathophysiology, relevance and treatment-a comprehensive review. Annals of intensive care, 14(1) Springer 10.1186/s13613-024-01336-9
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In this review, we aimed to comprehensively summarize current literature on pathophysiology, relevance, diagnosis and treatment of fluid accumulation in patients with sepsis/septic shock. Fluid accumulation syndrome (FAS) is defined as fluid accumulation (any degree, expressed as percentage from baseline body weight) with new onset organ-failure. Over the years, many studies have described the negative impact of FAS on clinically relevant outcomes. While the relationship between FAS and ICU outcomes is well described, uncertainty exists regarding its diagnosis, monitoring and treatment. A stepwise approach is suggested to prevent and treat FAS in patients with septic shock, including minimizing fluid intake (e.g., by limiting intravenous fluid administration and employing de-escalation whenever possible), limiting sodium and chloride administration, and maximizing fluid output (e.g., with diuretics, or renal replacement therapy). Current literature implies the need for a multi-tier, multi-modal approach to de-resuscitation, combining a restrictive fluid management regime with a standardized early active de-resuscitation, maintenance fluid reduction (avoiding fluid creep) and potentially using physical measures such as compression stockings.Trial registration: Not applicable.
Item Type: |
Journal Article (Review Article) |
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Division/Institute: |
04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > Clinic of Intensive Care |
UniBE Contributor: |
Pfortmüller, Carmen |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
2110-5820 |
Publisher: |
Springer |
Language: |
English |
Submitter: |
Pubmed Import |
Date Deposited: |
22 Jul 2024 16:20 |
Last Modified: |
22 Jul 2024 16:29 |
Publisher DOI: |
10.1186/s13613-024-01336-9 |
PubMed ID: |
39033219 |
Uncontrolled Keywords: |
De-resuscitation Fluid accumulation Fluids Monitoring Resuscitation Safety |
BORIS DOI: |
10.48350/199121 |
URI: |
https://boris.unibe.ch/id/eprint/199121 |
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