A recent article by Ahlstedt et al. published in Intensive Care Medicine examining the impact of restrictive fluid management on lactate clearance in septic shock patients within the intensive care unit (ICU) piqued our interest.

While they found no significant benefit for lactate clearance, several aspects warrant further investigation.

The pre-randomization infusion volume may have influenced lactate clearance.

The Crystalloid Liberal or Vasopressor Early Resuscitation in Sepsis trial, a multicenter, randomized, unblinded study com-paring restrictive fluid strategies (early vasopressor use) with liberal fluid therapy, found no mortality difference at 90 days.

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