Recent Advances in Fluids and Electrolyte Management in Sepsis

Abstract

Sepsis condition can cause life-threatening complications including organ dysfunction, circulatory failure, or mortality. Electrolyte abnormalities, including hyperkalaemia, hyponatremia, hypophosphatemia, and hypocalcaemia, have been observed in the later stages of sepsis due to cellular damage or ion channel dysfunction. Fluid resuscitation has been suggested as the common intervention to improve the patient’s condition when in septic shock. Fluids can help in an enhanced distribution of both intravascular and extravascular compartments, thereby increasing cardiac output. Timely fluid administration has shown improved survival rates with fewer severe microcirculatory alterations and mitochondrial dysfunctions. Fluid and electrolyte management is an effective strategy for treating sepsis but certain factors including timing, dosage, type of fluid and the health status of the individual needs to be carefully considered. Early intervention therapy seems to be effective in individuals with sepsis and has minimized the requirement for additional fluid administration. Certain aspects of fluid management including the future potentiality of dynamic fluid responsiveness and the role of albumin administration in sepsis treatment still need to be clarified. This review focuses on the updated management strategies that can be used for fluid and electrolyte management in individuals with sepsis. Keywords: Sepsis; Fluid resuscitation; electrolyte replacement therapy; albumin; intravenous therapy; septic shock Highlights In patients with sepsis, fluid resuscitation has been an effective intervention and earlier administration of therapy has minimized the need for additional fluid administration. Future research lends scope for improvement and advancements in electrolyte replacement therapy, effects of resuscitation, the effectiveness of fluid responsiveness and role of albumin in fluid management.