Precision Resuscitation With Crystalloids in Sepsis

Thirty-day mortality

Fluids are one of the most common treatments given to patients in the hospital. Fluids are
 especially important in treating patients with sepsis. Multiple clinical studies have
 compared the two main types of fluids used in sepsis (normal saline and balanced
 crystalloids). However, these studies have not found a clear benefit of one type of fluid
 versus the other. Which fluid should be given to which patient is an essential question
 because of the ubiquity of this intervention. Even a small difference in mortality could
 drastically change the standards of care given the national (and worldwide) scale of this
 intervention. The investigators have developed an algorithm that uses bedside vital signs
 (temperature, heart rate, respiratory rate, and blood pressure) to identify a group of
 patients (Group D) who have a significant mortality benefit from balanced crystalloids. The
 study randomizes adult patients in emergency departments across 6 Emory hospitals belonging
 to Group D to intervention versus usual care. The intervention arm involves a prompt to
 clinicians to use balanced crystalloids rather than normal saline.