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Erstad BL, Barletta JF. Challenges With Using a Weight-Based Approach to Bolus Fluid Dosing in Obese Critically Ill Patients. Ann Pharmacother 2022; 57:609-616. [PMID: 36086809 DOI: 10.1177/10600280221125169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
At least 30 mL/kg of crystalloid fluid administration within the first 3 hours of resuscitation is suggested by the current Surviving Sepsis Campaign guidelines for management of sepsis and septic shock. This commentary discusses the challenges with using a weight-based approach to bolus fluid dosing during the early phase of resuscitation of adult, obese patients. Based on the available literature, arguments can be made for the use of either ideal or adjusted body weight for weight-based fluid dosing, but there are concerns with fluid overload if using actual body weight to dose patients with more severe forms of obesity.
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Affiliation(s)
- Brian L. Erstad
- Department of Pharmacy Practice & Science, The University of Arizona, Tucson, AZ, USA
| | - Jeffrey F. Barletta
- Department of Pharmacy Practice, College of Pharmacy, Midwestern University, Glendale, AZ, USA
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