How Strong Is Your Deresuscitation Game in Sepsis Patients?

As much as I am not a huge fan of bombarding septic shock patients with IV fluids, I understand there is a role for fluid resuscitation.
When our patients get better, though, it is time to get rid of these fluids.
That is what we call deresuscitation.
It is part of the 4 D’s in fluid therapy: drug, duration, dosing, and deresuscitation.
Giving too much fluids to begin with is bad, just check out the Michelin Man example in this paper.
The primary goal should be to not give too much, but it’s hard to get it just right.
This paper was recently published and explains, as the title states, “Everything you need to know about deresuscitation“.
Hat tip to the authors. Read these free papers for yourself.
They use this ROSE model.
R for resuscitation.
O for optimization.
S for stabilization.
E for evacuation.
They list various hemodynamic, pulmonary, echocardiographic triggers for fluid evacuation, some of which I personally had never heard of.
Importantly, they also discuss when to stop deresuscitation.
Obviously a hypotensive and hypoperfused patient would check off these boxes.
Resuscitation is sexy, but so is deresuscitation.
To learn more about fluid responsiveness, CLICK HERE.

How Strong Is Your Deresuscitation ...
How Strong Is Your Deresuscitation Game in Sepsis Patients?

Citations for Deresuscitation

Malbrain MLNG, Van Regenmortel N, Saugel B, De Tavernier B, Van Gaal PJ, Joannes-Boyau O, Teboul JL, Rice TW, Mythen M, Monnet X. Principles of fluid management and stewardship in septic shock: it is time to consider the four D’s and the four phases of fluid therapy. Ann Intensive Care. 2018 May 22;8(1):66. doi: 10.1186/s13613-018-0402-x. PMID: 29789983; PMCID: PMC5964054.
Link to Article
Link to FULL FREE PDF

Malbrain MLNG, Martin G, Ostermann M. Everything you need to know about deresuscitation. Intensive Care Med. 2022 Aug 6:1–6. doi: 10.1007/s00134-022-06761-7. Epub ahead of print. PMID: 35932335; PMCID: PMC9362613.
Link to Article
Link to FULL FREE PDF

How to Support My Work

My efforts are at no cost to you and I would like to keep it that way. You have to look at ads on this website, listen to them on my podcast and YouTube content. Thanks for bearing with me. You could also support my work by clicking on my Amazon Affiliate links prior to ordering things off of Amazon.

For example, if you want to learn more about Mechanical Ventilation, I recommend starting off with The Ventilator Book by Will Owens. If you click on that link, a window for Amazon will open up and I will earn between a 1-3% commission at no expense to you. The fun thing is that if you order anything else on Amazon, I will earn that amount off of your shopping cart even if you do not purchase the book. Pretty cool, right? In 2020, Amazon Affiliates helped me pay for the hosting of my website, LLC fees, and Netflix.

Disclaimer

Although great care has been taken to ensure that the information in this post is accurate, eddyjoe, LLC shall not be held responsible or in any way liable for the continued accuracy of the information, or for any errors, omissions or inaccuracies, or for any consequences arising therefrom.