{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T12:53:16Z","timestamp":1772801596147,"version":"3.50.1"},"reference-count":19,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,9,30]],"date-time":"2022-09-30T00:00:00Z","timestamp":1664496000000},"content-version":"vor","delay-in-days":272,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acute Medicine &amp; Surgery"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:sec><jats:title>Aim<\/jats:title><jats:p>Administration of at least 30\u2009mL\/kg of fluid as fluid resuscitation is recommended for patients with sepsis and signs of hypoperfusion. However, it is not clear whether this is appropriate for patients with a do\u2010not\u2010intubate (DNI) order. This study evaluated the association between volume of fluid resuscitation and outcomes in patients with infection, signs of hypoperfusion, and a DNI order in an emergency department.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a single\u2010center retrospective cohort study. We classified the infected patients with signs of hypoperfusion and a DNI order seen in our emergency department between April 1, 2015 and November 31, 2020 into the standard fluid resuscitation group (\u226530\u2009mL\/kg) and the restricted fluid resuscitation group (&lt;30\u2009mL\/kg). We compared with in\u2010hospital mortality and the rate of discharge to home in two groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 367 patients, 149 received standard fluid resuscitation and 218 received restricted fluid resuscitation. In\u2010hospital mortality was similar in each group (40\/149 and 62\/218, respectively). Standard fluid resuscitation was not associated with in\u2010hospital mortality (adjusted odds ratio [aOR], 1.05; 95% confidence interval [CI], 0.62\u20131.77, <jats:italic>P<\/jats:italic>\u2009=\u20090.86), but was associated with a significantly lower rate of discharge to home (aOR, 0.55; 95% CI, 0.30\u20130.98, <jats:italic>P<\/jats:italic>\u2009=\u20090.043). There was no significant difference in respiratory rate or need for oxygen therapy post\u2010resuscitation between the two groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study suggests that fluid resuscitation may be not beneficial for infected patients with signs of hypoperfusion and a DNI order. Further studies should be conducted on the options for resuscitation management for these patients.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ams2.795","type":"journal-article","created":{"date-parts":[[2022,10,1]],"date-time":"2022-10-01T03:49:42Z","timestamp":1664596182000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Fluid resuscitation of at least 30\u2009<scp>mL<\/scp>\/kg was not associated with decreased mortality in patients with infection, signs of hypoperfusion, and a do\u2010not\u2010intubate order"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1807-6893","authenticated-orcid":false,"given":"Wataru","family":"Matsuda","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine and Critical Care Center Hospital of the National Center for Global Health and Medicine  Toyama, Shinjuku, Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5621-4142","authenticated-orcid":false,"given":"Yumi","family":"Funato","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine and Critical Care Center Hospital of the National Center for Global Health and Medicine  Toyama, Shinjuku, Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Momoyo","family":"Miyazaki","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine and Critical Care Center Hospital of the National Center for Global Health and Medicine  Toyama, Shinjuku, Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Koichiro","family":"Tomiyama","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine and Critical Care Center Hospital of the National Center for Global Health and Medicine  Toyama, Shinjuku, Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,9,30]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-019-05828-2"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrc.2016.06.030"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000005337"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000003119"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1703058"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000003892"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40560-021-00555-7"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1711584"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.0287"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000003831"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrc.2019.02.006"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-018-5342-2"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-018-5433-0"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000003960"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2019.09.029"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000003082"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.12788\/jhm.3329"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrc.2018.08.018"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-016-1360-z"}],"container-title":["Acute Medicine &amp; 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