Fluids
Fluid resuscitation is essential to prevent
hypotension and improve cardiac output
and therefore tissue perfusion. Many patients with sepsis are significantly dehydrated
so high levels of fluid resuscitation
are often needed. The SSC currently recommends
30ml/kg of crystalloids for
patients with hypotension or raised lactate
(>4mmol) (Dellinger et al, 2013). Lower volumes
of fluid, given in intermittent
boluses, should be considered in uncomplicated
sepsis and reviewed regularly for
efficacy. Lower volumes should also be
considered for those with active heart or
renal failure.