Can Retrospective Research Shed Light on the Role of Fluids for Sepsis in the Prehospital Setting?

To determine whether prehospital fluid administration is associated with in-hospital mortality in sepsis, investigators in Canada reviewed emergency services and hospital records for 1871 patients ultimately diagnosed with sepsis. They compared mortality in patients who did versus those who did not receive intravenous fluids in the prehospital setting. The investigators had no control over who did and did not receive fluids.

About half the patients received IV fluids in the prehospital setting (median volume, 400 mL). Patients who received fluids were more likely to die than those who did not receive fluids. However, among hypotensive patients, those who received fluids were less likely to die. Among nonhypotensive patients, there was no ass…