Association of active fluid de-escalation timing with clinical outcomes in patients with septic shock: a multicenter cohort study.

ABSTRACT:

Background

Early fluid resuscitation is a basic therapy for patients with septic shock but may lead to fluid overload associated with poor clinical outcomes. Active de-escalation (accumulated fluid removal using diuretics or ultrafiltration) is a crucial part of fluid management.

Methods

In this retrospective cohort study, patients were classified as the early group (with septic shock receiving active de-escalation within 24 h after hemodynamic stability) and late group. The primary outcome was 28-day mortality. Secondary outcomes included use of mechanical ventilation and renal replacement therapy, incidence of kidney injury and hemodynamic deterioration. Landmark analysis and restricted cubic splines based on Cox regression were performed.

Results

A total of 5,782 p

SUBMITTER: Zhuang R 

PROVIDER: S-EPMC12918465 | biostudies-literature | 2026 Jan

REPOSITORIES: biostudies-literature