{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T01:01:00Z","timestamp":1792198860228,"version":"4.4.0"},"reference-count":75,"publisher":"Walter de Gruyter GmbH","issue":"3","license":[{"start":{"date-parts":[[2023,7,1]],"date-time":"2023-07-01T00:00:00Z","timestamp":1688169600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Septic shock is a common condition associated with hypotension and organ dysfunction. It is associated with high mortality rates of up to 60% despite the best recommended resuscitation strategies in international guidelines. Patients with septic shock generally have a Mean Arterial Pressure below 65 mmHg and hypotension is the most important determinant of mortality among this group of patients. The extent and duration of hypotension are important. The two initial options that we have are 1) administration of intravenous (IV) fluids and 2) vasopressors, The current recommendation of the Surviving Sepsis Campaign guidelines to administer 30 ml\/kg fluid cannot be applied to all patients. Complications of fluid over-resuscitation further delay organ recovery, prolong ICU and hospital length of stay, and increase mortality. The only reason for administering intravenous fluids in a patient with circulatory shock is to increase the mean systemic filling pressure in a patient who is volume-responsive, such that cardiac output also increases. The use of vasopressors seems to be a more appropriate strategy, the very early administration of vasopressors, preferably during the first hour after diagnosis of septic shock, may have a multimodal action and potential advantages, leading to lower morbidity and mortality in the management of septic patients. Vasopressor therapy should be initiated as soon as possible in patients with septic shock.<\/jats:p>","DOI":"10.2478\/jccm-2023-0022","type":"journal-article","created":{"date-parts":[[2023,8,10]],"date-time":"2023-08-10T09:53:07Z","timestamp":1691661187000},"page":"138-147","source":"Crossref","is-referenced-by-count":34,"title":["Fluids and Early Vasopressors in the Management of Septic Shock: Do We Have the Right Answers Yet?"],"prefix":"10.2478","volume":"9","author":[{"given":"E.","family":"Carlos Sanchez","sequence":"first","affiliation":[{"name":"Department of Critical Care Medicine , King Salman Hospital , Riyadh , Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael R.","family":"Pinsky","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine , University of Pittsburgh School of Medicine , Pittsburgh , PA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharmili","family":"Sinha","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine , Apollo Hospitals , Bhubaneswar , India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajesh Chandra","family":"Mishra","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine , Ahmedabad Khyati Multi-speciality Hospitals , Ahmedabad , India Department of Critical Care Medicine , Ahmedabad Shaibya Comprehensive Care Clinic , Ahmedabad , India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahsina Jahan","family":"Lopa","sequence":"additional","affiliation":[{"name":"ICU and Emergency Department , Shahabuddin Medical College Hospital , Dhaka , Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ranajit","family":"Chatterjee","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, accident and emergency , Swami Dayanand Hospital Delhi , India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2023,7,31]]},"reference":[{"key":"2024042711435301603_j_jccm-2023-0022_ref_001","doi-asserted-by":"crossref","unstructured":"Singer M, Deutschman CS, Seymour CW, et al. 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