Fluids in sepsis

Despite being considered one of the cornerstones of treatment, many aspects of intravenous fluid administration to patients with sepsis remain controversial. While recent data have provided considerable insights, there remains uncertainty as to the type, rate and volume of fluid that should be administered. In addition, the appropriate balance between fluids and vasopressors to achieve adequate end-organ perfusion at various stages of the septic insult is open to debate. Nonetheless, there is increasing evidence that the volume, nature and timing of fluid given can have a significant influence upon patient outcome. Finally, the conventional paradigms regarding fluid administration and fluid bolus therapy are being increasingly challenged by newer evidence.