Gram negative bacteria produce endotoxins when they infect a host, which leads to a severe sepsis-like condition and derangement of the normal blood clotting pathways. A collaborative study between KEMRI-WTRP and the Critical Care Research Group (CCRG), Brisbane in an ovine model of endotoxic-shock showed that fluid resuscitation using normal saline, a commonly used fluid in clinical settings, led to worsening of the already deranged blood clotting pathways compared to sheep not receiving saline resuscitation (controls). Some of the reported changes seen after fluid resuscitation included decrease in blood pH, delayed clot initiation and formation as well as deficiencies in some of the naturally occurring anti-clotting proteins.
Fluid resuscitation remains an important pillar recommended in clinical guidelines for the treatment of septic shock patients. More research is however needed towards optimising the type, volume and rate of fluid to be administered for resuscitation of septic shock. Read more