Comorbidities, Weight-Based Initial Fluid Resuscitation, and Mortality in Patients With Sepsis

Among patients with community-onset sepsis, is administration of 30 mL/kg or more of fluid within 6 hours of hospital arrival associated with 30-day mortality?In this cohort study of 25 481 adult patients, administering at least 30 mL/kg of fluid vs less fluid was associated with lower adjusted 30-day mortality rates in patients without severe comorbidities who had hypoperfusion (26% vs 30%) or intermediate lactate levels (12% vs 14%). For patients with hypoperfusion and severe cardiac or kidney comorbidities, spline models showed an association between increased fluid volumes and decreased mortality.These findings suggest administration of at least 30 mL/kg of fluid to patients with community-onset sepsis may reduce mortality.

Corresponding Author: Elizabeth S. Munroe, MD, MSc, Department of Pulmonary and Critical Care, Intermountain Medical Center, 5121 S Cottonwood St, Murray, UT 84107 (elizabeth.munroe@imail.org).

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