Higher fluids in the first three hours of sepsis resuscitation? Too soon to conclude.

Th e authors used electronic medical records (EMRs) to identify patients with severe sepsis and septic shock. “Sepsis onset time” was determined by fl uidresistant hypotension, vasopressor use, or a lactate level . 4 mmol/L. 1 Th e reliability and validity of the outcome data in EMR-based interventional studies depend on the accuracy of data collection, entry, and storage. A study conducted on the Veterans Administration’s EMRs, a highly integrated and standardized EMR system, showed that 60% of the patients had one or more input-related errors, with an average of 7.8 errors per patient. 2