The recommendation for the initial fluid bolus is based upon expert opinion and actual body weight.
There was no specific bolus prescribed in the original EGDT study. The only bolus referenced in that study was the 20-30 ml/kg/30 min bolus used to exclude from the study hypotensive patients who responded to the bolus. That, of course, does not mean that all patients in the study received no bolus, but whatever unspecified bolus they received, and total 6 hour fluid requirements, were determined by judgments about severity and phase of illness, comorbidities, and most importantly the amount of fluid actually required to achieve resuscitation goals. EGDT group required a mean of 5 L at 6 hours but standard deviations were huge with estimated range of 1 - 11 L. Ron Elkin MD California Pacific Medical Center San Francisco On Wed, Oct 23, 2013 at 5:04 AM, Brown, Sheree < [email protected]> wrote: > Several physicians I work with insist that the initial fluid bolus (30 > mL/kg) should be based on ideal body weight, not actual body weight. Where > can I find specific documentation regarding this issue?**** > > Thanks, **** > > Sheree**** > > ** ** > > ** ** > > --**** > > *Sheree Brown MSN, RN, CNL* > > Clinical Quality Specialist, Emergency Services**** > > Performance Excellence**** > > Phone: 517 788-4800 ext. 4209**** > > Pager: 517 534-0127**** > > Fax: 517 788-4715 **** > > [email protected] <http://allegiancehealth.org>**** > > [image: email-signature-mcgaw]**** > > ** ** > > ------------------------------ > This e-mail message and any attachment(s) is intended only for the > individual(s) to whom it is addressed and may contain information that is > privileged, confidential or proprietary in nature. Any unauthorized > disclosure, copying or distribution of this e-mail or the content of this > message is prohibited. If you have received this e-mail message in error, > please immediately notify the sender at the e-mail address above, > permanently delete this e-mail and destroy any copies of this e-mail and > attachments in your possession. This electronic message (“e-mail”), > including the typed name of the sender, does not constitute an electronic > signature unless there is a specific statement to the contrary included in > this e-mail. > > _______________________________________________ > Sepsisgroups mailing list > [email protected] > http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org > >
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