Category: Critical Care
Keywords: 30 ml/kg, sepsis, fluid overload, ESRD, CHF (PubMed Search)
Have you ever encountered an ESRD patient who missed dialysis because the patient "felt too sick to go to dialysis"? The patient then had hypotension from an infected catheter line? Do we give 30 ml/kg of balanced fluid now?
Title: Outcomes of CMS-mandated ?uid administration among ?uid-overloaded patients with sepsis: A systematic review and meta-analysis.
Settings: This is a meta-analysis
Patients: Septic patients who have underlying fluid overload conditions (CHF or ESRD).
Intervention: intravenous fluid administration according to the mandate by the Center for Medicare/Medicaid as 30 ml per kilograms of bodyweight.
Comparison: fluid administration at less than 30 ml/kg of body weight.
Outcome: 30-day mortality, rates of vasopressor requirement, rates of invasive mechanical ventilation
Pence M, Tran QK, Shesser R, Payette C, Pourmand A. Outcomes of CMS-mandated fluid administration among fluid-overloaded patients with sepsis: A systematic review and meta-analysis. Am J Emerg Med. 2022 May;55:157-166. doi: 10.1016/j.ajem.2022.03.004. Epub 2022 Mar 10. PMID: 35338881.