Restriction of Intravenous Fluid in ICU Patients with Septic Shock

To the Editor: In the Conservative versus Liberal Approach to Fluid Therapy of Septic Shock in Intensive Care (CLASSIC) trial, Meyhoff et al. (June 30 issue)(1) found similar numbers of death at 90 days in patients with septic shock who received resuscitation with a restrictive-fluid strategy (42.3%) and in those who received resuscitation with a liberal-fluid (standard) approach (42.1%). Because resuscitative fluids were allowed to be used in the restrictive-fluid group only in the case of severe hypoperfusion - requiring, among other signs, a mean arterial pressure of less than 50 mm Hg despite administration of vasopressor agents or inotropes . . .