Background: Critically ill patients with sepsis usually receive a very large volume of fluids cau-sing a very significant positive fluid balance in an effort to meet the needs of cardiac output, syste-mic blood pressure, and perfusion to the kidneys. This condition also tends to be associated with poor survival rates. The aim of this study was to determine whether early maintenance of norepi-nephrine can reduce fluid administration and prevent overload in the resuscitation of patients with septic shock. Methods: This study was a randomized, non-blind clinical trial, of which the subjects were adult patients with septic shock admitted to the intensive and emergency care unit from January to November 2020. There were two treatment groups of this study, the early norepinephrine group (NEP group) and the 30 ml/kgBW fluid resuscitation one (Fluid group). The test was con-ducted on the urinary albumin-to-creatinine ra-tio, increase of serum creatinine value, ratio of arterial oxygen partial pressure to fractional in-spired oxygen (PaO2/FiO2 ratio), and intra-ab-dominal pressure at the time of septic shock di-agnosis was established, 3 hours, and 24 hours . after the treatment was given. The data was pro-cessed using the SPSS device. Results: Based on the analysis, it was found that there were significant differences in all study va-riables of the Fluid group compared to the NEP group. The amount of fluid administration in the NEP group averaged 2198.63 ml, less than that in the Fluid group with an average of 3999.30 ml (chi square test p=0.000). By comparing the measurement results to the initial measurement values in the two groups, the fluid overload was high-risk in the Fluid group. There was a significant relationship between the urinary albumin-to-creatinine ratio (OR=48.273; 95% CI=16.708-139.472), the increase in serum crea-tinine value (OR=73.381; 95% CI=19.955-269.849), the low PaO2/FiO2 ratio (OR=12.225; 95% CI=5.290-28.252), and the increase in intra-abdominal pressure (OR=32.667; 95% CI=10.490-101.724) with the provision of 30 ml/kgBW fluid resuscitation, which indicated the risk of fluid overload. Conclusion: Early norepinephrine administration can reduce fluid administration and prevent overload in the resuscitation of patients with septic shock.
|Number of pages||12|
|Journal||Critical Care and Shock|
|Publication status||Published - 2021|
- Early norepinephrine
- Fluid overload
- Septic shock