Too much of a good thing; Does fluid resuscitation worsen septic shock?

Is fluid resuscitation ineffective for the treatment of endotoxemic shock and does it result in unintended cardiovascular dysfunction?

Grant ID: EMPJ-358R25-2016

Lay Summary

Patients with infections are a leading cause of presentations to the Emergency Department (ED), with severe sepsis and infection causing an estimated 20,000 deaths each day across the world. Treatment is aimed at eradicating the infection and supporting the patient while recovery can take place. Frequently patients develop low blood pressure as a result of immune response that can ultimately result in further organ injury (termed septic shock). Intravenous fluids are recommended by international guidelines as the first line therapy in the ED to treat low blood pressure of sepsis with the hope of preventing organ injury and death.

Despite 50 years of use in sepsis, the rationale for fluids remains based in theory rather than clear evidence it is effective in saving lives. Disconcertingly, there is now increasing evidence that fluids in sepsis are ineffective and may actually worsen patient survival. Despite this fluids continue to be recommended and used liberally in the ED resulting in conflict between our historical practice and the best evidence. We have developed an animal model of septic shock and resuscitation in order to test the effectiveness of fluid resuscitation. This will allow us to both understand the true effect but also investigate the underlying physiological mechanisms of any harms.

Leveraged Funds

- This research is also funded by an $AUD 980,810.56 NHMRC grant: Understanding tissue responses to fluid resuscitation and blood transfusion during ovine sepsis to improve outcomes [ 2014 - 2017 ] Also known as: Resuscitation in Endotoxaemic Shock - Understanding Sepsis (RESUS)


Amount Awarded


Grant Scheme


Principal Investigator:
Prof Louise Cullen

Co Investigators:
Prof John Fraser
A/Prof Kiran Shekar
Dr Liam Bryne
Dr Obonyo Nchfatso
Dr Connie Boon
Dr Louise See Ho
Margaret Passmore
Prof Kathryn Maitland


Collaborating Institutions


  • Effects of volume resuscitation on the microcirculation in animal models of lipopolysaccharide sepsis: a systematic review

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