Volumentherapie in der Sepsis: Wann ist das Limit erreicht?

Background: The endpoints of volume resuscitation in severe sepsis and septic shock are still a subject of discussion at the bedside. Method: Based on guidelines and current literature, recommended end points as well as the results and side effects of volume resuscitation are reported on. Results: If volume resuscitation is not successful within 6 h, additional hemodynamic monitoring is recommended for measuring surrogate parameters of tissue oxygenation and preload as well as for predicting volume responsiveness. Over-resuscitation may result in anasarca and life-threatening side effects such as fluid lung, abdominal compartment syndrome, and decrease in cardiac output. Conclusion: Adverse effects of volume resuscitation and over-resuscitation are not always avoidable; however, adequate monitoring may limit negative effects on the patients' outcome.