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Letters to the Editor

Indian Pediatrics 2005; 42:733-844-845

Fluid Resuscitation in Septic Shock

In reference to recent article(1) on this subject, we have the following comments to offer:

1. In the study, authors have compared the efficacy of saline with degraded gelatin in saline. So they have compared the crystalloid with colloid in crystalloid. The study would have been more authenticated if comparison would have been made between crystalloid and pure colloid as 5% albumin, fresh frozen plasma, synthetic colloid solutions (heta starch, dextran 40, dextran 60).

2. Authors have used fluid boluses even after 6 hours up to 24 hours of fluid resuscitation. Ideally, if the administration of 60mL/kg of crystalloid results in no improvement in septic shock, myocardial dysfunction should be considered. That needs the inotropic support in the form of dopamine or epinephrine(2).

K.K. Locham,
Manpreet Sodhi,

Department of Pediatrics,
Government Medical College,
Patiala 147 001, Punjab, India.



1. Upadhyay M, Singhi S, Murlidharan J, Kaur N, Majumdar S. Randomized evaluation of fluid resusucitation with crystalloid (saline) and colloid (polymer from degraded gelatin in saline) in pediatric septic shock. Indian Pediatr 2005; 42: 223-231.

2. Stormorken A, Powell KR, Sepsis and Shock. In: Behrman RE, Kliegman RM, Jenson HB, editors. Nelson Textbook of Pediatrics. 17th ed. New Delhi: Elsevier; 2004, p 846-850.


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