Saudi Cultural Missions Theses & Dissertations
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Item Restricted Restrictive Versus Liberal or Standard Intravenous Fluid Administration in Patients with Sepsis or Septic Shock: A Systematic Review(Queen Mary University of London, 2024-07-31) Khogeer, Tariq; Prowle, JohnSepsis and septic shock are leading causes of morbidity and mortality worldwide, with effective management being critical to improving patient outcomes. Intravenous (IV) fluid resuscitation is a cornerstone of treatment in septic patients; however, the optimal fluid management strategy remains controversial. This systematic review examines the impact of restrictive versus liberal or standard fluid resuscitation strategies on mortality in patients with sepsis or septic shock. The review included eight randomized controlled trials (RCTs) involving 2,375 patients. The primary outcome was mortality within 90 days. Secondary outcomes included the use of mechanical ventilation, vasopressor requirements, renal replacement therapy, and the occurrence of adverse events such as limb ischemia and acute kidney injury. The findings suggest no significant difference in mortality between restrictive and liberal fluid administration. However, restrictive strategies may reduce the need for mechanical ventilation and vasopressor support. These results highlight the need for individualized fluid resuscitation strategies in septic patients, tailored to clinical circumstances. Further large-scale studies are recommended to confirm these findings and optimize fluid management protocols.13 0Item Restricted IV Vitamin C as an Adjunctive Therapy in Sepsis and Sepsis Shock.(Saudi Digital Library, 2023-10) Alawad, Norah; Hart, RobertIn my systematic literature search, I aim to thoroughly explore the use of vitamin C, as an adjunctive therapy, in the management of sepsis and septic shock. Since the latter possess significant challenges in the practice of critical care, I believe this necessitates the exploration of other supportive therapies that enhances the patients’ outcomes. By conducting a thorough search in multiple databases, my project investigated the plausibility of using vitamin C in sepsis and septic shock and how this may influence different outcomes, most importantly, the mortality rate. Furthermore, my project will dive into a comprehensive examination of high quality randomised controlled trials (RCTs), outlining in details the process of the critical appraisal and how my conclusion is based on this analysis. Finally, the findings of this project will shed the light on the implications, future recommendations, and current unanswered questions related to the use of vitamin C. This will potentially lead to an enhancement of the patients’ care and providing innovative approaches for upcoming research as well as improving the treatment protocols in the critical care settings.13 0