• Crit Care · Jan 2011

    Review

    Totem and taboo: fluids in sepsis.

    • Andrew K Hilton and Rinaldo Bellomo.
    • Department of Intensive Care, Alfred Hospital, Commercial Road, Melbourne, Australia, Victoria 3181, Australia.
    • Crit Care. 2011 Jan 1;15(3):164.

    AbstractThe need for early, rapid, and substantial fluid resuscitation in septic patients has long been an article of faith in the intensive care community, a tribal totem that is taboo to question. The results of a recent multicenter trial in septic children in Africa, published in The New England Journal of Medicine, powerfully challenge the fluid paradigm. The salient aspects of the trial need to be understood and reflected upon. In this commentary, we discuss the background to and findings of the trial and explain why they will likely trigger a re-evaluation of our thinking about fluids in sepsis, a re-evaluation that is already happening in the treatment of acute respiratory distress syndrome and acute kidney injury and in postoperative care.

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