Whether to fill up the pipes fully with fluids before starting vasopressors or whether to start vasopressors early, even with half-filled pipes during septic shock resuscitation, has been intensely debated in recent times. There are concerns about both approaches.
Boyd JH, Forbes J, Nakada TA, et al. Fluid resuscitation in septic shock: a positive fluid balance and elevated central venous pressure are associated with increased mortality. Crit Care Med 2011;39(2):259–265. DOI: 10.1097/CCM.0b013e3181feeb15
Malbrain MLNG, Van Regenmortel N, Saugel B, et al. Principles of fluid management and stewardship in septic shock: it is time to consider the four D's and the four phases of fluid therapy. Ann Intensive Care 2018;8(1):66. DOI: 10.1186/s13613-018-0402-x
Cinel I, Kasapoglu US, Gul F, et al. The initial resuscitation of septic shock. J Crit Care 2020;57:108–117. DOI: 10.1016/j.jcrc.2020.02.004
Bagshaw SM, Cruz DN. Fluid overload as a biomarker of heart failure and acute kidney injury. Contrib Nephrol 2010;164:54–68. DOI: 10.1159/000313721
Stolk RF, Pickkers P, Kox M, et al. Potentially inadvertent immunomodulation: norepinephrine use in sepsis. Am J Respir Crit Care Med 2016;194(5):550–558. DOI: 10.1164/rccm.201604-0862CP
Roberts RJ, Miano TA, Hammond DA, et al. Observation of variation in fluids administered in shock-characterization of vasopressor requirements in shock (volume-chasers) study group and SCCM discovery network. evaluation of vasopressor exposure and mortality in patients with septic shock. Crit Care Med 2020;48(10):1445–1453. DOI: 10.1097/CCM.0000000000004476
Hippensteel JA, Uchimido R, Tyler PD, et al. Intravenous fluid resuscitation is associated with septic endothelial glycocalyx degradation. Crit Care 2019;23(1):259. DOI: 10.1186/s13054-019-2534-2
