Iceman 🥶 @CALEBcsw cometh Week 6: 4-2 #DaBears 🐻🏈 #TheHobby

Can we please stop treating sepsis like a hydration problem? #Nephpearls #AKIinICU 📌 More IV fluids ≠ better resuscitation Yes, hypovolemia matters. Yes, early fluids can be lifesaving. But once you’ve restored enough preload, continuing to pour liters into a patient who isn’t fluid responsive can become harmful rather than helpful. The question shouldn’t be: “How much more fluid can I give?” It should be: “Will the patient actually benefit from more fluid?” Sepsis is a problem of perfusion, vasodilation, distributive shock, altered microcirculation, and - often- cardiac dysfunction. A patient can be hypotensive and still be adequately or even excessively volume-loaded. And there’s a cost to the reflexive “another liter” approach: pulmonary edema, impaired oxygenation, tissue edema, abdominal compartment issues, worsening organ function, and a harder road to recovery. Fluids are a tool. They are not the treatment for every hypotensive septic patient. ✅ Assess fluid responsiveness. Reassess after interventions. Use dynamic measures when appropriate. And recognize when the physiology is telling you that it’s time for vasopressors—not another bag of saline. ✅ Sepsis resuscitation should be physiology-driven, not liter-driven. – at Riverside, IL