North Trent Critical Care Network

Written by Critical Care In this issue of Critical Care, pig experiments are reported, in which, after induction of septic shock, a 'liberal' fluid loading protocol was compared to a more 'restrictive' one, regarding haemodynamics and mortality. It appeared that the former was associated with higher mortalityin spite of improved haemodynamics as compared to the latter. The results of the paper are discussed in view of the scope and mechanisms of these findings. They favor that too much of an otherwise good thing in fluid resuscitation is harmful, even if overhydration and edema formation seem prevented. They also do not exclude a specific toxic effect of the larger volumes of hydroxyethyl starch in the 'liberal' strategy. The precisenature of a toxic effect remains obscure, however, but may involve the kiodneys.

Authors: Johan Groeneveld

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