Maintenance Fluid Rate for Adults With Sepsis
No fixed “maintenance” IV fluid rate is recommended for adults with sepsis after initial resuscitation. Fluid administration should be individualized after an initial bolus with frequent ongoing reassessment to avoid under-resuscitation and fluid overload. [1]
Initial Fluid Strategy Requiring Dose-Defined Delivery
For adults with sepsis-induced hypoperfusion or septic shock, at least 30 mL/kg of IV crystalloid should be administered within the first 3 hours. [1]
Post-Resuscitation Fluid Administration Approach
After the initial fluid bolus, additional fluids should be guided by clinical response and reassessment rather than by continuing a preset maintenance rate. [1]
Perfusion-Guided Ongoing Reassessment
Serial lactate measurement should be used to guide resuscitation, and fluid administration should be individualized after the initial bolus rather than continued until lactate normalization. [1]
Fluid Type Principles Relevant to Maintenance-Phase Therapy
Balanced crystalloids are suggested over 0.9% saline for initial resuscitation in adults with sepsis or septic shock. [1]