Pre-operative fluid resuscitation in the emergency general surgery septic patient: does it really matter?

Abstract Objective Emergency general surgery (EGS) patients presenting with sepsis remain a challenge. The Surviving Sepsis Campaign recommends 30 mL/kg fluid bolus in these patients, but recent studies suggest an association between large volume crystalloid resuscitation and increased mortality. optimal amount of pre-operative prior to source control intra-abdominal is unknown. This study aims determine if increasing surgical associated worsening outcomes. Methods We conducted 8-year retrospective chart review EGS undergoing for abdominal within 24 h admission. Patients hemorrhagic shock those outside hospital index surgeries were excluded. grouped by 10 ml/kg intervals up > 70 later them into < or ≥ ml/kg. A relative risk regression model compared amounts administration. Mortality was the primary outcome measure. Secondary outcomes time operation, ventilator days, length stay (LOS). Groups quick Sequential Organ Failure Assessment (qSOFA) SOFA scoring systems. Results Of 301 included, mean age 55, 51% male, 257 (85%) survived discharge. With per kg (< ml/kg), there mortality decile, 8.8% versus 31.6% ( p = 0.004). who received had lower (11.3 vs 21%) than 0.02). These groups median qSOFA scores (1.0 vs. 1.0, 0.06). There no differences operation (6.1 4.9 0.11), days (1 3, 0.08), LOS (8 9 0.57). Relative correcting physiologic factors showed significant groups. Conclusions Greater volumes initially significantly higher mortality, despite similar organ failure scores. However, not following adjustment other model. ICU LOS.