Evidence-based fluid resuscitation of the septic HFpEF patient: A narrative review of the literature

TL;DR

This review explores how to best manage fluid resuscitation in septic patients with heart failure with preserved ejection fraction.

Contribution

The paper provides a focused narrative review on fluid resuscitation strategies for septic patients with HFpEF.

Findings

HFpEF in septic patients is linked to higher risk of adverse outcomes.

Individualized fluid resuscitation approaches may be beneficial for this population.

New tools for assessing fluid responsiveness show promise but require further study.

Abstract

This narrative review aims to highlight the available evidence on fluid resuscitation in septic patients with heart failure, with a particular focus on heart failure with preserved ejection fraction.

A PubMed search was conducted using the keywords “sepsis” (or sepsis, or septic shock), “heart failure” (or HF, or HFrEF, or HFpEF or congestive heart failure), and “fluid” (or resuscitation, or fluid resuscitation, or fluid management). The results were summarized in narrative review format.

The presence of HFpEF in septic patients appears to be associated with an increased risk of adverse outcomes. This population may benefit from a more individualized approach to fluid resuscitation. Emerging tools for assessing fluid responsiveness and characterizing septic cardiovascular physiology show promise, but further investigation is needed.