Intensive Care Medicine

, Volume 44, Issue 6, pp 791–798 | Cite as

Expert statement for the management of hypovolemia in sepsis

  • Anders PernerEmail author
  • Maurizio Cecconi
  • Maria Cronhjort
  • Michael Darmon
  • Stephan M. Jakob
  • Ville Pettilä
  • Iwan C. C. van der Horst


Hypovolemia is frequent in patients with sepsis and may contribute to worse outcome. The management of these patients is impeded by the low quality of the evidence for many of the specific components of the care. In this paper, we discuss recent advances and controversies in this field and give expert statements for the management of hypovolemia in patients with sepsis including triggers and targets for fluid therapy and volumes and types of fluid to be given. Finally, we point to unanswered questions and suggest a roadmap for future research.


Critical care Fluid therapy Hemodynamics Hypovolemia Sepsis Shock 


Compliance with ethical standards

Conflicts of interest

AP is a member of the steering committee and Danish national investigator of the Sepsis Act vasopressin trial in septic shock sponsored by Ferring Pharmaceuticals; his department is reimbursed for his time. The department also receives research funds from Fresenius Kabi (the EAT-ICU nutrition trial) and CSL Behring (the INSTINCT trial on immunoglobulins for NSTI). MCe reports being a consultant in the last 5 years for Edwards Lifesciences, LiDCO, and Cheetah Medical. The other authors report no conflicts of interest.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature and ESICM 2018

Authors and Affiliations

  1. 1.Department of Intensive Care, RigshospitaletUniversity of CopenhagenCopenhagenDenmark
  2. 2.Department Anaesthesia and Intensive Care Units, IRCCS Istituto Clinico HumanitasHumanitas UniversityMilanItaly
  3. 3.Department of Clinical Science and EducationSödersjukhuset, Karolinska InstitutetStockholmSweden
  4. 4.Medical ICUSaint-Louis University Hospital, AP-HPParisFrance
  5. 5.ECSTRA Team, Biostatistics and Clinical Epidemiology, UMR 1153 (Center of Epidemiology and Biostatistic Sorbonne Paris Cité, CRESS)INSERMParisFrance
  6. 6.Paris-7 Medical SchoolUniversité Paris-DiderotParisFrance
  7. 7.Department of Intensive Care MedicineUniversity Hospital Bern (Inselspital), University of BernBernSwitzerland
  8. 8.Department of Anesthesiology, Intensive Care and Pain MedicineUniversity of Helsinki and Helsinki University HospitalHelsinkiFinland
  9. 9.Department of Critical Care, University Medical Center GroningenUniversity of GroningenGroningenThe Netherlands

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