{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T19:40:49Z","timestamp":1785872449093,"version":"3.56.0"},"reference-count":40,"publisher":"SAGE Publications","issue":"11","license":[{"start":{"date-parts":[[2023,6,8]],"date-time":"2023-06-08T00:00:00Z","timestamp":1686182400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["5UL1TR002389-02"],"award-info":[{"award-number":["5UL1TR002389-02"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Intensive Care Med"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>The dose and timing of early fluid resuscitation in sepsis remains a debated topic. The objective of this study is to evaluate the effect of fluid timing in early sepsis management on mortality and other clinical outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Single-center, retrospective cohort study of emergency-department-treated adults (&gt;18 years, n\u2009=\u20091032) presenting with severe sepsis or septic shock. Logistic regression evaluating the impact of 30\u2005mL\/kg crystalloids timing and mortality-versus-time plot controlling for mortality in emergency department sepsis score, lactate, antibiotic timing, obesity, sex, systemic inflammatory response syndrome criteria, hypotension, and heart and renal failures. This study is a subanalysis of a previously published investigation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Mortality was 17.1% (n\u2009=\u2009176) overall and 20.4% (n\u2009=\u2009133 of 653) among those in septic shock. 30\u2005mL\/kg was given to 16.9%, 32.2%, 16.2%, 14.5%, and 20.3% of patients within \u22641, 1\u2009\u2264\u20093, 3\u2009\u2264\u20096, 6\u2009\u2264\u200924, and not reached within 24\u2005h, respectively. A 24-h plot of adjusted mortality versus time did not reach significance, but within the first 12\u2005h, the linear function showed a per-hour mortality increase (odds ratio [OR] 1.29, 95% confidence interval [CI] 1.02-1.67) which peaks around 5h, although the quadratic function does not reach significance ( P\u2009=\u2009.09). When compared to patients receiving 30\u2005mL\/kg within 1\u2005h, increased mortality was observed when not reached within 24\u2005h (OR 2.69, 95% CI 1.37-5.37) but no difference when receiving this volume between 1 and 3 (OR 1.11, 95% CI 0.62-2.01), 3 and 6 (OR 1.83, 95% CI 0.97-3.52), or 6 and 24\u2005h (OR 1.51, 95% CI 0.75-3.06). Receiving 30\u2005mL\/kg between 1 and 3 versus &lt;1\u2005h increased the incidence of delayed hypotension (OR 1.83, 95% CI 1.23-2.72) but did not impact need for intubation, intensive care unit admission, or vasopressors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>We observed weak evidence that supports that earlier is better for survival when reaching fluid goals of 30\u2005mL\/kg, but benefits may wane at later time points. These findings should be viewed as hypothesis generating.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/08850666231180530","type":"journal-article","created":{"date-parts":[[2023,6,8]],"date-time":"2023-06-08T03:04:30Z","timestamp":1686193470000},"page":"1051-1059","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":8,"title":["The Effect of Fluid Resuscitation Timing in Early Sepsis Resuscitation"],"prefix":"10.1177","volume":"38","author":[{"given":"Hani I.","family":"Kuttab","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine, University of Wisconsin-Madison, Madison, WI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chad G.","family":"Evans","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, University of Wisconsin-Madison, Madison, WI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph D.","family":"Lykins","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine & Internal Medicine, Virginia Commonwealth University Health System, Richmond, VA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle D.","family":"Hughes","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, University of Wisconsin-Madison, Madison, WI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason A.","family":"Kopec","sequence":"additional","affiliation":[{"name":"Division of Emergency Medicine, Carle Foundation Hospital, Urbana, IL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael A.","family":"Hernandez","sequence":"additional","affiliation":[{"name":"Division of Pulmonary, Critical Care and Sleep Medicine, University of Washington, Seattle, WA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5760-5890","authenticated-orcid":false,"given":"Michael A.","family":"Ward","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, University of Wisconsin-Madison, Madison, WI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2023,6,8]]},"reference":[{"key":"bibr1-08850666231180530","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa010307"},{"key":"bibr2-08850666231180530","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1404380"},{"key":"bibr3-08850666231180530","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1401602"},{"key":"bibr4-08850666231180530","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1500896"},{"key":"bibr5-08850666231180530","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrc.2017.08.025"},{"key":"bibr6-08850666231180530","doi-asserted-by":"publisher","DOI":"10.5603\/AIT.a2017.0056"},{"key":"bibr7-08850666231180530","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000003119"},{"key":"bibr8-08850666231180530","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000005337"},{"key":"bibr9-08850666231180530","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2021.02.006"},{"key":"bibr10-08850666231180530","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e3181feeb15"},{"key":"bibr11-08850666231180530","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-016-4675-y"},{"key":"bibr12-08850666231180530","doi-asserted-by":"publisher","DOI":"10.1186\/cc13072"},{"key":"bibr13-08850666231180530","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-015-0970-1"},{"key":"bibr14-08850666231180530","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000002189"},{"key":"bibr15-08850666231180530","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000003960"},{"key":"bibr16-08850666231180530","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-020-2819-5"},{"key":"bibr17-08850666231180530","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201507-1489OC"},{"key":"bibr18-08850666231180530","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2016.02.044"},{"key":"bibr19-08850666231180530","doi-asserted-by":"publisher","DOI":"10.1016\/j.jemermed.2021.03.004"},{"key":"bibr20-08850666231180530","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0256368"},{"issue":"6","key":"bibr21-08850666231180530","first-page":"537","volume":"30","author":"Jeong WI","year":"2019","journal-title":"J Korean Soc Emerg Med"},{"key":"bibr22-08850666231180530","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)61602-X"},{"key":"bibr23-08850666231180530","unstructured":"R: A language and environment for statistical computing. 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