• Heath E Latham, Charles D Bengtson, Lewis Satterwhite, Mindy Stites, Dipti P Subramaniam, G John Chen, and Steven Q Simpson.
• Division of Pulmonary and Critical Care Medicine, The University of Kansas Medical Center, 3901 Rainbow Blvd, MS 3007, Kansas City, KS 66160, United States. Electronic address: hlatham@kumc.edu.
• J Crit Care. 2017 Dec 1; 42: 42-46.

AbstractTo determine whether stroke volume (SV) guided fluid resuscitation in patients with severe sepsis and septic shock alters Intensive Care Unit (ICU) fluid balance and secondary outcomes, this retrospective cohort study evaluated consecutive patients admitted to an ICU with the primary diagnosis of severe sepsis or septic shock. Cohorts were based on fluid resuscitation guided by changes in SV or by usual care (UC). The SV group comprised 100 patients, with 91 patients in the UC group. Net fluid balance for the ICU stay was lower in the SV group (1.77L) than in the UC group (5.36L) (p=0.022). ICU length of stay was 2.89days shorter (p=0.03) and duration of vasopressors was 32.8h less (p=0.001) in the SV group. SV group required less mechanical ventilation (RR, 0.51; p=0.0001). The SV group was less likely to require acute hemodialysis (6.25%) compared with the UC group (19.5%) (RR, 0.32; p=0.01). In multivariable analysis, SV was an independent predictor of lower fluid balance, LOS, time on vasopressors, and not needing mechanical ventilation. This study demonstrated that SV guided fluid resuscitation in patients with severe sepsis and septic shock was associated with reduced fluid balance and improved secondary outcomes.Copyright © 2017 Elsevier Inc. All rights reserved.

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