Scribd
Upload
169 views1 page

Fluid Resuscitation for Sepsis Management

This document outlines a fluid resuscitation algorithm for adults presenting with sepsis. It recommends giving patients presenting with hypotension a minimum of 30mls/kg of isotonic crystalloid intravenously in the first hour, unless they are fluid intolerant. It provides guidance on assessing for signs of hypovolaemia or fluid overload and monitoring lactate levels to guide further fluid administration and treatment. The algorithm emphasizes continuous monitoring, reassessment, and exercising clinical judgement tailored to individual patient comorbidities.

Uploaded by

Sorina Biliuta
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
169 views1 page

Fluid Resuscitation for Sepsis Management

This document outlines a fluid resuscitation algorithm for adults presenting with sepsis. It recommends giving patients presenting with hypotension a minimum of 30mls/kg of isotonic crystalloid intravenously in the first hour, unless they are fluid intolerant. It provides guidance on assessing for signs of hypovolaemia or fluid overload and monitoring lactate levels to guide further fluid administration and treatment. The algorithm emphasizes continuous monitoring, reassessment, and exercising clinical judgement tailored to individual patient comorbidities.

Uploaded by

Sorina Biliuta
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

Fluid resuscitation algorithm

for adults with sepsis

Hypotension: Hypoperfusion:
SBP < 90mmHg or > 40mmHg Tachycardia
drop from baseline OR Vasoconstriction
or Oligouria
MAP < 65mmHg Lactate ≥ 2mmol/L

Give bolus 500mls isotonic crystalloid over 15 minutes


and reassess
Give patients who present with hypotension a minimum
of 30mls/kg in the 1st hour, unless fluid intolerant

Hypovolaemia: Fluid overloaded


• Altered mental state
• Increasing respiratory rate
• Hypotension
• Hypoperfused • Decreasing O saturations 30mls/kg IVT
- tachycardia • JVP distension administered
- cold mottled peripheries • New onset crepitations
- prolonged capillary refill • New onset discomfort
• Oligouria lying flat
• Raised lactate
15-minute reviews and
continous monitoring

Normotensive Hypotensive Hypotensive Normotensive


+ or or +
Repeat Lactate Repeat Lactate Repeat Lactate Repeat Lactate
< 2mmol/L ≥ 2mmol/L ≥ 4mmol/L < 4mmol/L

• Stop all IVT • Stop all IVT • High mortality • Continue fluid
• Consider diuretic • Vasopressors risk resuscitation as
• Continue fluid above until Lactate
• NIV or intubation • NIV or intubation
resuscitation as < 2mmol/L as
as indicated as indicated
above tolerated, then stop
• Continuous • Not for diuretic • 1/2-hourly
• Consider
monitoring
Mochua Print & Design | [Link] | 09/08/2018

• Continuous Vasopressors observations


monitoring • Reassess and treat
• Continuous
• Call Critical Care monitoring if hypoperfusion /
• Call Critical Care hypotension
reoccurs

Exercise professional judgement – if patient co-morbidity indicates use 250ml boluses


and reassess more frequently.

SBP: Systolic blood pressure, MAP: Mean arterial pressure, JVP: Jugular venous pressure, IVT: Intravenous therapy, NIV: Noninvasive ventilation
For more information on National Clinical Guideline No 6. Sepsis Management go to: [Link]/sepsis

You might also like