Fluid pretest

What is the annual incidence of sepsis in the US?

• 1.7 million
• 2 million
• 3 million
• 4 million

Which of the following is a true statement regarding the seminal Early Goal Directed Therapy study published in the NEJM in 2001?

• It likely resulted in unnecessary RBC transfusions.

• It likely resulted in unnecessary fluid administration.

• We found out that most people required 4L of crystalloid

• It used IVC collapsibility to determine fluid responsiveness

Answer explanation

Patients did, on average, receive 4L of crystalloid but the range was squite wide (from about 2-6L).

However, the way that the fluid or RBCs were administered was according to resuscitation targets such as CVP, MAP and ScvO2.

How much does 1L of NS cost?

• Whatever change you find in the couch

• $5-$10

• $50-$100

• >$500

Answer explanation

About a dollar!

How much does 1L of Lactated Ringers cost?

• Whatever change you find in your couch

• $5-$10

• $50-$100

• >$500

Answer explanation

About $2-$3.

How much does 1L of Normosol cost?

• Whatever change you find in your couch

• $5-$10

• $50-$100

• >$500

Answer explanation

How much does 1L of 5% Albumin cost?

• Whatever change is in your couch

• $5-$10

• $50-$100

• >$500

Answer explanation

This human derived resuscitation product is incredibly expensive...

One liter of 5% albus about $600

Why are we still talking about albumin vs. crystalloid in sepsis? Wasn't there a meta-analysis published in 2011 which showed that patients resuscitated with albumin had a reduction in mortality (OR=0.850)?

• That's what I've been asking!

• I have no idea what you're talking about.

• 

Answer explanation

Which devices below are appropriate tools for fluid resuscitation?

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