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Physiological changes after fluid bolus therapy in sepsis: a systematic review of contemporary data

Glassford, Neil J, Eastwood, Glenn M and Bellomo, Rinaldo 2014, Physiological changes after fluid bolus therapy in sepsis: a systematic review of contemporary data, Critical care, vol. 18, pp. 1-21, doi: 10.1186/s13054-014-0696-5.

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Title Physiological changes after fluid bolus therapy in sepsis: a systematic review of contemporary data
Author(s) Glassford, Neil J
Eastwood, Glenn M
Bellomo, Rinaldo
Journal name Critical care
Volume number 18
Article ID 696
Start page 1
End page 21
Total pages 21
Publisher BioMed Central
Place of publication London, Eng.
Publication date 2014-12-27
ISSN 1466-609X
Summary Fluid bolus therapy (FBT) is a standard of care in the management of the septic, hypotensive, tachycardic and/or oliguric patient. However, contemporary evidence for FBT improving patient-centred outcomes is scant. Moreover, its physiological effects in contemporary ICU environments and populations are poorly understood. Using three electronic databases, we identified all studies describing FBT between January 2010 and December 2013. We found 33 studies describing 41 boluses. No randomised controlled trials compared FBT with alternative interventions, such as vasopressors. The median fluid bolus was 500 ml (range 100 to 1,000 ml) administered over 30 minutes (range 10 to 60 minutes) and the most commonly administered fluid was 0.9% sodium chloride solution. In 19 studies, a predetermined physiological trigger initiated FBT. Although 17 studies describe the temporal course of physiological changes after FBT in 31 patient groups, only three studies describe the physiological changes at 60 minutes, and only one study beyond this point. No studies related the physiological changes after FBT with clinically relevant outcomes. There is a clear need for at least obtaining randomised controlled evidence for the physiological effects of FBT in patients with severe sepsis and septic shock beyond the period immediately after its administration.
Language eng
DOI 10.1186/s13054-014-0696-5
Field of Research 110399 Clinical Sciences not elsewhere classified
11 Medical And Health Sciences
Socio Economic Objective 970111 Expanding Knowledge in the Medical and Health Sciences
HERDC Research category C1.1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2014, The Authors
Free to Read? Yes
Use Rights Creative Commons Attribution licence
Persistent URL http://hdl.handle.net/10536/DRO/DU:30086903

Document type: Journal Article
Collections: Faculty of Health
School of Nursing and Midwifery
Open Access Collection
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Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.