Daniel J. Pallin, MD, MPH reviewing Leisman D et al. Ann Emerg Med 2016 Apr 14.

An observational study shows a mortality benefit from early administration of intravenous fluids in sepsis patients.

Early antibiotics and fluid resuscitation are the cornerstones of current treatment for sepsis. To determine if initiation of intravenous (IV) fluids within 30 minutes of recognition of sepsis improves outcomes, investigators reviewed prospectively collected data from a single center during a 13-month period.

Of 1866 patients with severe sepsis or septic shock, 64% had IV fluids initiated within 30 minutes. The early-fluids group had significantly lower mortality (13.3% vs. 18.3%) and hospital stay (median, 6 vs. 7 days). In a multivariable analysis that controlled for variables including age, lactate level, hypotension, acute organ dysfunction, and Emergency Severity Index score, IV fluid initiation within 30 minutes was associated with 0.63 lower odds of mortality and 12% shorter hospital stay.

Citation(s):

Leisman D et al. Association of fluid resuscitation initiation within 30 minutes of severe sepsis and septic shock recognition with reduced mortality and length of stay. Ann Emerg Med 2016 Apr 14; [e-pub].

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