These trials address the fundamental question we ask ourselves in resuscitating patients: Lactated Ringers or Normal Saline? These trials are thought provoking and may even be practice changing for those who preferentially resuscitate with saline. A question that came up while reading the SMART trial was whether the amount of fluid administered in these groups affected the outcomes.
The SMART trial reported that median volume of fluid resuscitation in both treatment groups was approximately 1000mL. This volume is lower than I would expect, as we often see patients with septic shock in the ICU receiving at least 30ml/kg within the first few hours of presentation. Specifically, is there a subgroup analysis of patients with septic shock that depicts the volume of fluid administered in each group? Do you think that the amount of volume administered in this study affected the outcomes?
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