{
  "abstract": "Objectives We set out to describe the amount of fluid administered within the first 24 hours of sepsis treatment with an exploratory analysis of associations.Design This prospective observational study used data from the Sepsis Epidemiology in Australian and New Zealand Emergency Departments Study, collected from 2021 to 2023.Patients Participants were children aged 0 years to <18 years with suspected community-acquired sepsis admitted to the hospital through 11 emergency departments in Australia and New Zealand.Main outcomes We describe the volumes of fluid administered and mortality rates associated with different fluid volumes.Results A total of 5352 patients were included in the analysis, with a median age of 2.6 years (IQR 0.4–7.5 years), in-hospital mortality of 58 (1.1%), and 293 (5.5%) of whom met Phoenix sepsis criteria. The median total volume of fluid administered over the initial 24 hours of hospitalisation was 40.0 mL/kg (IQR 20.6–61.5 mL/kg), including: bolus fluid 10.0 mL/kg (IQR 9.4–19.9 mL/kg), maintenance fluid 27.1 mL/kg (IQR 10.2–47.3 mL/kg) and medication carrier fluid 0.0 mL/kg (IQR 0.0–0.9 mL/kg). In-hospital mortality increased with increasing volume of bolus fluid but not with increasing volume of total fluid (unadjusted OR for in-hospital mortality for >55 mL/kg vs <15 mL/kg bolus fluid: 20.5, 95% CI 8.0 to 52.5; p<0.001).Conclusion Although maintenance fluids accounted for the largest proportion of total fluid volume, bolus fluids showed the strongest association with in-hospital mortality in unadjusted analyses.",
  "authors": [
    {
      "affiliations": [
        "Emergency, The Royal Children’s Hospital Melbourne, Melbourne, Victoria, Australia",
        "Murdoch Children’s Research Institute, Parkville, Victoria, Australia",
        "Department of Paediatrics, Faculty of Medicine, Dentistry, and Health Sciences, The University of Melbourne, Parkville, Victoria, Australia",
        "Department of Critical Care, Faculty of Medicine, Dentistry, and Health Sciences, The University of Melbourne, Parkville, Victoria, Australia"
      ],
      "name": "Elliot Long"
    },
    {
      "affiliations": [
        "Murdoch Children’s Research Institute, Parkville, Victoria, Australia"
      ],
      "name": "Christopher Selman"
    },
    {
      "affiliations": [
        "Emergency Medicine, Perth Children’s Hospital, Nedlands, Western Australia, Australia",
        "Divisions of Paediatrics and Emergency Medicine, University of Western Australia, Crawley, Western Australia, Australia"
      ],
      "name": "Meredith Louise Borland"
    },
    {
      "affiliations": [
        "Emergency Department, Gold Coast University Hospital, Southport, Queensland, Australia",
        "School of Medicine and Dentistry, Griffith University, Southport, Queensland, Australia"
      ],
      "name": "Shane George"
    },
    {
      "affiliations": [
        "Department of Emergency Medicine, The Children’s Hospital at Westmead, Sydney, New South Wales, Australia",
        "The University of Sydney, Sydney, New South Wales, Australia"
      ],
      "name": "Shefali Jani"
    },
    {
      "affiliations": [
        "Emergency Department, Middlemore Hospital, Auckland, Auckland, New Zealand",
        "The University of Auckland, Auckland, Auckland, New Zealand"
      ],
      "name": "Eunicia Tan"
    },
    {
      "affiliations": [
        "Emergency Department, Queensland Children’s Hospital, Children’s Health Queensland Hospital and Health Service, South Brisbane, Queensland, Australia",
        "University of Queensland Child Health Research Centre, South Brisbane, Queensland, Australia"
      ],
      "name": "Natalie Phillips"
    },
    {
      "affiliations": [
        "Pediatric Emergency, Women's and Children’s Health Network, North Adelaide, South Australia, Australia"
      ],
      "name": "Amit Kochar"
    },
    {
      "affiliations": [
        "Monash Medical Centre Clayton, Clayton, Victoria, Australia"
      ],
      "name": "Simon Craig"
    },
    {
      "affiliations": [
        "Paediatrics, Royal Darwin Hospital, Casuarina, New South Wales, Australia"
      ],
      "name": "Anna Lithgow"
    },
    {
      "affiliations": [
        "Emergency, Townsville Hospital, Townsville City, Queensland, Australia"
      ],
      "name": "Emma Whyte"
    },
    {
      "affiliations": [
        "Murdoch Children’s Research Institute, Parkville, Victoria, Australia",
        "Department of Critical Care, Faculty of Medicine, Dentistry, and Health Sciences, The University of Melbourne, Parkville, Victoria, Australia",
        "Royal Children’s Hospital Paediatric Intensive Care Unit, Parkville, Victoria, Australia"
      ],
      "name": "Ben Gelbart"
    },
    {
      "affiliations": [
        "Murdoch Children’s Research Institute, Parkville, Victoria, Australia",
        "Department of Paediatrics, Faculty of Medicine, Dentistry, and Health Sciences, The University of Melbourne, Parkville, Victoria, Australia",
        "Department of General Medicine, The Royal Children's Hospital, Parkville, Victoria, Australia"
      ],
      "name": "Sarah McNab"
    },
    {
      "affiliations": [
        "Emergency, Starship Children’s Health, Auckland, Auckland, New Zealand",
        "Department of Surgery and Paediatrics: Child and Youth Health, The University of Auckland, Auckland, Auckland, New Zealand"
      ],
      "name": "Stuart Dalziel"
    },
    {
      "affiliations": [
        "Emergency, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA"
      ],
      "name": "Fran Balamuth"
    },
    {
      "affiliations": [
        "Intensive Care, Nemours Children’s Hospital Delaware, Wilmington, Delaware, USA"
      ],
      "name": "Scott L Weiss"
    },
    {
      "affiliations": [
        "Department of Pediatrics and Division of Emergency Medicine, George Washington University, Washington, DC, USA"
      ],
      "name": "Nathan Kuppermann"
    },
    {
      "affiliations": [
        "Murdoch Children’s Research Institute, Parkville, Victoria, Australia"
      ],
      "name": "Amanda Williams"
    },
    {
      "affiliations": [
        "Emergency, The Royal Children’s Hospital Melbourne, Melbourne, Victoria, Australia",
        "Murdoch Children’s Research Institute, Parkville, Victoria, Australia",
        "Department of Paediatrics, Faculty of Medicine, Dentistry, and Health Sciences, The University of Melbourne, Parkville, Victoria, Australia",
        "Department of Critical Care, Faculty of Medicine, Dentistry, and Health Sciences, The University of Melbourne, Parkville, Victoria, Australia"
      ],
      "name": "Franz E Babl"
    },
    {
      "affiliations": [],
      "name": "On behalf of the Paediatric Research in Emergency Departments International Collaborative (PREDICT) network"
    }
  ],
  "title": "IV bolus, maintenance and medication carrier fluid in children with community-acquired sepsis: a multicentre cohort study",
  "uid": "2ced33fc-bcca-5b2e-8705-800847af4b95"
}