Dynamic testing-based versus restrictive-based fluid administration following early fluid resuscitation in septic shock patients: a pilot randomized controlled trial study

Abstract

Purpose
Compare the restrictive fluid versus the dynamic testing strategy in septic shock.


Methods
This study was a randomized controlled trial that enrolled 80 consecutive patients who had been diagnosed with septic shock and were managed in accordance with the guidelines of SSC. The study was carried out in the Critical Care Department of Cairo University. Patients were assigned (1:1) into the restrictive group (predetermined fluid administration rate of 1 ml/kg/hour), and the dynamic testing group.


Results
Eighty patients were enrolled. Clinical severity scores were higher in the restrictive group. Logistic regression revealed no significant difference in the adjusted in-hospital mortality rate (hazard’s risk 0.913, P 0.903, CI 95% 0.212–3.935). The fluid strategy did not affect the need for dialysis, mechanical ventilation, or the length of stay in the intensive care unit.


Conclusions
The restrictive fluid strategy demonstrated similarity to a dynamic-based strategy concerning in-hospital mortality rates, the requirement for ventilation, dialysis, and the length of stay in the intensive care unit.