The effects of hypertonic fluid administration in patients with severe sepsis or septic shock

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Patients with severe sepsis (infection) frequently die. Sepsis interferes with the clotting and inflammatory systems and affects the heart, blood pressure as well as tissue oxygenation of the body. Vigorous fluid administration can restore the volume necessary to ensure blood and oxygen are carried around the body but may not be sufficient for good tissue perfusion. Hypertonic fluid which has a higher concentration of salt, is thought to both increase heart function and improve the flow of blood and oxygen into the micro tissues that supply the body. It is also thought to improve immune function. In this study we hope to randomise 24 eligible Intensive Care patients with severe sepsis, into two groups; a control group which will receive 500mls of 6% HES solution and the treatment group which will receive 250mls of Hyperhes hypertonic fluid. A variety of invasive and non-invasive measurements and blood tests will be taken over a six hour period. Demographic data and illness severity scores will be recorded as well as usual haemodynamic measures and recordings for seriously ill patients. Statistical analysis using standard techniques, will be done on SPSS version 10.0 Hyperhes, evaluated in previous studies, is regarded as a safe and well tolerated treatment for shock.

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