{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T03:11:33Z","timestamp":1792465893323,"version":"4.5.0"},"reference-count":86,"publisher":"Georg Thieme Verlag KG","issue":"05","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Semin Respir Crit Care Med"],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Intravenous fluid administration remains an important component in the care of patients with septic shock. A common error in the treatment of septic shock is the use of excessive fluid in an effort to overcome both hypovolemia and vasoplegia. While fluids are necessary to help correct the intravascular depletion, vasopressors should be concomitantly administered to address vasoplegia. Excessive fluid administration is associated with worse outcomes in septic shock, so great care should be taken when deciding how much fluid to give these vulnerable patients. Simple or strict \u201crecipes\u201d which mandate an exact amount of fluid to administer, even when weight based, are not associated with better outcomes and therefore should be avoided. Determining the correct amount of fluid requires the clinician to repeatedly assess and consider multiple variables, including the fluid deficit, organ dysfunction, tolerance of additional fluid, and overall trajectory of the shock state. Dynamic indices, often involving the interaction between the cardiovascular and respiratory systems, appear to be superior to traditional static indices such as central venous pressure for assessing fluid responsiveness. Point-of-care ultrasound offers the bedside clinician a multitude of applications which are useful in determining fluid administration in septic shock. In summary, prevention of fluid overload in septic shock patients is extremely important, and requires the careful attention of the entire critical care team.<\/jats:p>","DOI":"10.1055\/s-0041-1733898","type":"journal-article","created":{"date-parts":[[2021,9,20]],"date-time":"2021-09-20T22:39:12Z","timestamp":1632177552000},"page":"698-705","source":"Crossref","is-referenced-by-count":12,"title":["Optimizing Fluid Resuscitation and Preventing Fluid Overload in Patients with Septic Shock"],"prefix":"10.1055","volume":"42","author":[{"given":"Chandni","family":"Ravi","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, University of Nebraska Medical Center, Omaha, Nebraska"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel W.","family":"Johnson","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, University of Nebraska Medical Center, Omaha, Nebraska"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2021,9,20]]},"reference":[{"issue":"20","key":"ref1","doi-asserted-by":"crossref","first-page":"1471","DOI":"10.1056\/NEJM199305203282008","article-title":"Pathogenetic mechanisms of septic shock","volume":"328","author":"J E Parrillo","year":"1993","journal-title":"N Engl J Med"},{"issue":"01","key":"ref2","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1016\/j.ccc.2017.08.005","article-title":"Pathophysiology of septic shock","volume":"34","author":"J A Russell","year":"2018","journal-title":"Crit Care Clin"},{"issue":"03","key":"ref3","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1093\/bja\/aev349","article-title":"A rational approach to fluid therapy in sepsis","volume":"116","author":"P Marik","year":"2016","journal-title":"Br J Anaesth"},{"issue":"05","key":"ref4","doi-asserted-by":"crossref","first-page":"e291","DOI":"10.1097\/PCC.0000000000002266","article-title":"The endothelial glycocalyx: a fundamental determinant of vascular permeability in sepsis","volume":"21","author":"J Fern\u00e1ndez-Sarmiento","year":"2020","journal-title":"Pediatr Crit Care Med"},{"issue":"01","key":"ref5","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1186\/s13054-019-2534-2","article-title":"Intravenous fluid resuscitation is associated with septic endothelial glycocalyx degradation","volume":"23","author":"J A Hippensteel","year":"2019","journal-title":"Crit Care"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1186\/s40560-017-0210-7","article-title":"Predicting the need for fluid therapy - Does fluid responsiveness work?","volume":"5","author":"H Ueyama","year":"2017","journal-title":"J Intensive Care"},{"issue":"19","key":"ref7","doi-asserted-by":"crossref","first-page":"1368","DOI":"10.1056\/NEJMoa010307","article-title":"Early goal-directed therapy in the treatment of severe sepsis and septic shock","volume":"345","author":"E Rivers","year":"2001","journal-title":"N Engl J Med"},{"issue":"04","key":"ref8","doi-asserted-by":"crossref","first-page":"1105","DOI":"10.1097\/01.CCM.0000259463.33848.3D","article-title":"Implementation of a bundle of quality indicators for the early management of severe sepsis and septic shock is associated with decreased mortality","volume":"35","author":"H B Nguyen","year":"2007","journal-title":"Crit Care Med"},{"issue":"19","key":"ref9","doi-asserted-by":"crossref","first-page":"2294","DOI":"10.1001\/jama.299.19.2294","article-title":"Improvement in process of care and outcome after a multicenter severe sepsis educational program in Spain","volume":"299","author":"R Ferrer","year":"2008","journal-title":"JAMA"},{"issue":"04","key":"ref10","doi-asserted-by":"crossref","first-page":"536","DOI":"10.1007\/s00134-004-2210-z","article-title":"Surviving Sepsis Campaign guidelines for management of severe sepsis and septic shock","volume":"30","author":"R P Dellinger","year":"2004","journal-title":"Intensive Care Med"},{"issue":"03","key":"ref11","doi-asserted-by":"crossref","first-page":"486","DOI":"10.1097\/CCM.0000000000002255","article-title":"Surviving Sepsis Campaign: international guidelines for management of sepsis and septic shock: 2016","volume":"45","author":"A Rhodes","year":"2017","journal-title":"Crit Care Med"},{"issue":"08","key":"ref12","doi-asserted-by":"crossref","first-page":"e185844","DOI":"10.1001\/jamanetworkopen.2018.5844","article-title":"Toward a more nuanced approach to the early administration of intravenous fluids in patients with sepsis","volume":"1","author":"C Rhee","year":"2018","journal-title":"JAMA Netw Open"},{"issue":"05","key":"ref13","doi-asserted-by":"crossref","first-page":"e2291","DOI":"10.1371\/journal.pone.0002291","article-title":"Why are clinicians not embracing the results from pivotal clinical trials in severe sepsis? 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