FLUid management and InDividualized resuscitation in Sepsis (FLUIDS)-A Study protocol for a single-centre,...

Area of Science:

• Critical Care Medicine
• Cardiovascular Physiology
• Emergency Medicine

Background:

• Sepsis causes complex hemodynamic disturbances like vasodilation and hypovolemia, necessitating prompt resuscitation.
• Current fluid administration in the emergency department (ED) lacks personalization, impacting patient tolerance and responsiveness.
• Personalized resuscitation strategies are crucial for managing sepsis effectively.

Purpose of the Study:

• To evaluate a personalized hemodynamic resuscitation strategy for sepsis in the ED.
• To utilize continuous non-invasive stroke volume index (SVI) measurements to guide intravenous (IV) fluid therapy and vasopressor initiation.
• To compare SVI-guided resuscitation with standard care in the initial management of sepsis.

Main Methods:

• A single-center, open-label, randomized clinical trial involving 188 adults with suspected sepsis.
• Patients randomized to either an SVI-guided intervention group or a standard care control group.
• Primary endpoint: IV fluid volume administered within the first three hours; secondary endpoints include organ failure, mortality, and fluid-related adverse events.

Main Results:

• Anticipated reduction in IV fluid volume with SVI-guided resuscitation compared to standard care.
• Personalized approach aims to tailor fluid and vasopressor administration to individual hemodynamic needs.
• Potential for improved patient outcomes in sepsis management.

Conclusions:

• SVI-guided resuscitation offers a personalized approach to sepsis management in the ED.
• This strategy may optimize fluid and vasopressor administration, potentially reducing complications.
• Further research is needed to confirm the benefits of personalized hemodynamic resuscitation in sepsis.