Fluid Resuscitation In The Setting Of Sepsis-Induced Hypotension

The protocol for the management of hypotension in the setting of septic shock has been long debated. Septic shock is a type of distributive shock where disseminated infection causes widespread vasodilation in the vascular network, leading to inefficient perfusion of organs and ultimately multiorgan failure, which can cause death if not compensated for. In the setting of severe sepsis, acute kidney injury may occur, leading to electrolyte and acid-base abnormalities, which can further contribute to mortality. Traditionally, fluid resuscitation and vasopressor administration have been utilized in order to help minimize end-organ damage secondary to malperfusion. The discussion of fluid resuscitation has been contentious, with the focus being on whether fluids should be given to patients in edematous states to begin with, and also on what type of crystalloid fluid should be given. This paper aims to review current protocol concerning whether normal saline (0.9% NaCl) or lactated Ringer's solution is more optimal for maintaining electrolyte and acid-base status in septic patients.