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 . . .