Liberal versus conservative fluid therapy in children and adults with sepsis or septic shock

Citation: Li D, Li X, Cui W, et al. Liberal versus conservative fluid therapy in adults and children with sepsis or septic shock. Cochrane Database of Systematic Reviews 2018; (12): CD010593

What is this? Sepsis and septic shock are life-threatening complications of infection. Fluid therapy, either conservative or liberal, is used during its initial treatment. This may have relevance for the treatment of some critically ill patients with COVID-19.

In this Cochrane systematic review, the authors searched for randomized and quasi-randomized trials comparing liberal fluid therapy versus conservative fluid therapy for patients with sepsis or septic shock. They did not restrict their searches by date or language of publication and did these in January 2018.  They identified 3 randomized trials in children (3402 participants) and were able to use data from 2 of these (3288 participants). The tested therapies varied across the trials. They found no trials in adults.

What works: Nothing noted.

What doesn’t work: Liberal fluid therapy carried a greater risk of death in children with sepsis and septic shock, and there was insufficient evidence to conclude that it had any beneficial effects on other outcomes, compared to conservative fluid therapy.

What’s uncertain: The effects of liberal versus conservative fluid therapy for adults with sepsis or septic shock are uncertain.

 

Disclaimer: This summary has been written by staff and volunteers of Evidence Aid in order to make the content of the original document accessible to decision makers who are searching for the available evidence on the coronavirus (COVID-19) but may not have the time, initially, to read the original report in full. This summary is not intended as a substitute for the medical advice of physicians, other health workers, professional associations, guideline developers, or national governments and international agencies. If readers of this summary think that the evidence that is presented within it is relevant to their decision-making they should refer to the content and details of the original article, and the advice and guidelines offered by other sources of expertise, before making decisions. Evidence Aid cannot be held responsible for any decisions made about the coronavirus (COVID-19) on the basis of this summary alone.

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