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Expert statement for the management of hypovolemia in sepsis

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Abstract

Hypovolemia is frequent in patients with sepsis and may contribute to worse outcome. The management of these patients is impeded by the low quality of the evidence for many of the specific components of the care. In this paper, we discuss recent advances and controversies in this field and give expert statements for the management of hypovolemia in patients with sepsis including triggers and targets for fluid therapy and volumes and types of fluid to be given. Finally, we point to unanswered questions and suggest a roadmap for future research.

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Authors and Affiliations

  1. Department of Intensive Care, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark

    Anders Perner

  2. Department Anaesthesia and Intensive Care Units, IRCCS Istituto Clinico Humanitas, Humanitas University, Milan, Italy

    Maurizio Cecconi

  3. Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden

    Maria Cronhjort

  4. Medical ICU, Saint-Louis University Hospital, AP-HP, Paris, France

    Michael Darmon

  5. ECSTRA Team, Biostatistics and Clinical Epidemiology, UMR 1153 (Center of Epidemiology and Biostatistic Sorbonne Paris Cité, CRESS), INSERM, Paris, France

    Michael Darmon

  6. Paris-7 Medical School, Université Paris-Diderot, Sorbonne-Paris-Cité, Paris, France

    Michael Darmon

  7. Department of Intensive Care Medicine, University Hospital Bern (Inselspital), University of Bern, Bern, Switzerland

    Stephan M. Jakob

  8. Department of Anesthesiology, Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland

    Ville Pettilä

  9. Department of Critical Care, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands

    Iwan C. C. van der Horst

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  1. Anders Perner
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  7. Iwan C. C. van der Horst
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Correspondence to Anders Perner.

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Conflicts of interest

AP is a member of the steering committee and Danish national investigator of the Sepsis Act vasopressin trial in septic shock sponsored by Ferring Pharmaceuticals; his department is reimbursed for his time. The department also receives research funds from Fresenius Kabi (the EAT-ICU nutrition trial) and CSL Behring (the INSTINCT trial on immunoglobulins for NSTI). MCe reports being a consultant in the last 5 years for Edwards Lifesciences, LiDCO, and Cheetah Medical. The other authors report no conflicts of interest.

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Perner, A., Cecconi, M., Cronhjort, M. et al. Expert statement for the management of hypovolemia in sepsis. Intensive Care Med 44, 791–798 (2018). https://doi.org/10.1007/s00134-018-5177-x

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  • DOI: https://doi.org/10.1007/s00134-018-5177-x

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