Fluid therapy in critically ill adults with sepsis- Risks and benefits

• A phase 3, randomized clinical trials (RCTs) in which 3723 patients with sepsis who received 1 to 2 L of fluid reported that goal-directed therapy administering fluid boluses did not decrease mortality compared with unstructured clinical care (24.9% vs 25.4%).
• Another RCT reported that among 1554 patients in the intensive care unit with septic shock treated with at least 1 L of fluid compared with more liberal fluid administration, restricting fluid administration without severe hypoperfusion did not reduce mortality (42.3% vs 42.1%).
• An RCT of 1000 patients with acute respiratory distress with limited fluid administration and diuretics improved the number of days alive without mechanical ventilation compared with fluid treatment to attain higher intracardiac pressure (14.6 vs 12.1 days).

Based on these various research articles, it can be concluded that although fluid therapy is vital in treating patients who are critically ill with sepsis, it remains uncertain and does not improve mortality with fluid therapy

.Fernando G. Zampieri also noted that clinicians should consider the risks and benefits of fluid administration in each phase of critical illness and facilitate fluid removal for patients recovering from acute respiratory distress syndrome.