Loren Ketai, MD
To the Editors: The review of cardiovascular function in patients with septic shock by Parrillo and colleagues (1) raises an important question about the efficacy of fluid loading in such patients. These investigators recommend initial fluid resuscitation to raise pulmonary capillary wedge pressure to 15 to 18 mm Hg. Data from a previous study by the same group (2) suggest that this course is not optimal. In this study, volume loading in patients with septic shock produced little improvement in ventricular performance despite achieving a mean pulmonary capillary wedge pressure of 16 mm Hg.
While failing to improve cardiovascular function,
Ketai L. Fluid Loading in Septic Shock. Ann Intern Med. ;113:991–992. doi: 10.7326/0003-4819-113-12-991
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Published: Ann Intern Med. 1990;113(12):991-992.
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