Effect of Fluid Resuscitation Strategies for Obese Patients with Sepsis and Septic Shock: A Systematic Review
Abstract Purpose As the Surviving Sepsis Campaign (2021) recommended, patients with sepsis should be given a liquid infusion of 30 ml/kg (ideal body weight). However, the strategy may result in insufficient resuscitation for obese patients with sepsis. Therefore, we conducted a systematic evaluation...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Springer
2022-10-01
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| Series: | Intensive Care Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1007/s44231-022-00019-y |
| _version_ | 1797636902707265536 |
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| author | Yijun Zhang Minjie Wang Zongqing Lu Min Yang |
| author_facet | Yijun Zhang Minjie Wang Zongqing Lu Min Yang |
| author_sort | Yijun Zhang |
| collection | DOAJ |
| description | Abstract Purpose As the Surviving Sepsis Campaign (2021) recommended, patients with sepsis should be given a liquid infusion of 30 ml/kg (ideal body weight). However, the strategy may result in insufficient resuscitation for obese patients with sepsis. Therefore, we conducted a systematic evaluation of the effectiveness of the initial resuscitation strategy in obese sepsis patients. Materials and methods A computer search of PubMed, Embase, Cochrane library, and other databases collected cohort studies from the beginning of the survey to December 2021 to include articles evaluating initial resuscitation strategies for sepsis-obese patients. Results Of the six studies included, five used ideal body weight infusion strategies, and three used actual body weight infusion strategies. Differences in fluid volume were observed between the two strategies, but no significant difference was observed in the mortality of obese sepsis patients. In addition, there may be an infusion strategy other than the above two infusion methods, and the safety and efficacy of the new infusion strategy are unclear. The obesity paradox has been observed in most infusion strategies. Conclusion The association between obesity and infusion strategy has rarely been investigated in patients with sepsis and septic shock, and the existing results are conflicting. The risk of bias in all included studies was moderate or high. Before providing broad recommendations on the optimal first resuscitation approach to lower the chance of mortality, further clinical trials, and prospective research need to be done. |
| first_indexed | 2024-03-11T12:40:45Z |
| format | Article |
| id | doaj.art-7aea3e828b2342e0b4fca92ffab66837 |
| institution | Directory Open Access Journal |
| issn | 2666-9862 |
| language | English |
| last_indexed | 2024-03-11T12:40:45Z |
| publishDate | 2022-10-01 |
| publisher | Springer |
| record_format | Article |
| series | Intensive Care Research |
| spelling | doaj.art-7aea3e828b2342e0b4fca92ffab668372023-11-05T12:18:52ZengSpringerIntensive Care Research2666-98622022-10-0131616810.1007/s44231-022-00019-yEffect of Fluid Resuscitation Strategies for Obese Patients with Sepsis and Septic Shock: A Systematic ReviewYijun Zhang0Minjie Wang1Zongqing Lu2Min Yang3The Laboratory of Cardiopulmonary Resuscitation and Critical Care Medicine, The Second Affiliated Hospital of Anhui Medical UniversityThe Laboratory of Cardiopulmonary Resuscitation and Critical Care Medicine, The Second Affiliated Hospital of Anhui Medical UniversityThe Laboratory of Cardiopulmonary Resuscitation and Critical Care Medicine, The Second Affiliated Hospital of Anhui Medical UniversityThe Laboratory of Cardiopulmonary Resuscitation and Critical Care Medicine, The Second Affiliated Hospital of Anhui Medical UniversityAbstract Purpose As the Surviving Sepsis Campaign (2021) recommended, patients with sepsis should be given a liquid infusion of 30 ml/kg (ideal body weight). However, the strategy may result in insufficient resuscitation for obese patients with sepsis. Therefore, we conducted a systematic evaluation of the effectiveness of the initial resuscitation strategy in obese sepsis patients. Materials and methods A computer search of PubMed, Embase, Cochrane library, and other databases collected cohort studies from the beginning of the survey to December 2021 to include articles evaluating initial resuscitation strategies for sepsis-obese patients. Results Of the six studies included, five used ideal body weight infusion strategies, and three used actual body weight infusion strategies. Differences in fluid volume were observed between the two strategies, but no significant difference was observed in the mortality of obese sepsis patients. In addition, there may be an infusion strategy other than the above two infusion methods, and the safety and efficacy of the new infusion strategy are unclear. The obesity paradox has been observed in most infusion strategies. Conclusion The association between obesity and infusion strategy has rarely been investigated in patients with sepsis and septic shock, and the existing results are conflicting. The risk of bias in all included studies was moderate or high. Before providing broad recommendations on the optimal first resuscitation approach to lower the chance of mortality, further clinical trials, and prospective research need to be done.https://doi.org/10.1007/s44231-022-00019-yObesitySepsisInitial fluid resuscitation |
| spellingShingle | Yijun Zhang Minjie Wang Zongqing Lu Min Yang Effect of Fluid Resuscitation Strategies for Obese Patients with Sepsis and Septic Shock: A Systematic Review Intensive Care Research Obesity Sepsis Initial fluid resuscitation |
| title | Effect of Fluid Resuscitation Strategies for Obese Patients with Sepsis and Septic Shock: A Systematic Review |
| title_full | Effect of Fluid Resuscitation Strategies for Obese Patients with Sepsis and Septic Shock: A Systematic Review |
| title_fullStr | Effect of Fluid Resuscitation Strategies for Obese Patients with Sepsis and Septic Shock: A Systematic Review |
| title_full_unstemmed | Effect of Fluid Resuscitation Strategies for Obese Patients with Sepsis and Septic Shock: A Systematic Review |
| title_short | Effect of Fluid Resuscitation Strategies for Obese Patients with Sepsis and Septic Shock: A Systematic Review |
| title_sort | effect of fluid resuscitation strategies for obese patients with sepsis and septic shock a systematic review |
| topic | Obesity Sepsis Initial fluid resuscitation |
| url | https://doi.org/10.1007/s44231-022-00019-y |
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