Initial resuscitation in sepsis includes which fluid regimen?

• A. Crystalloid 30 mL/kg over 30-60 minutes
• B. Colloid 20 mL/kg over 2 hours
• C. Whole blood transfusion
• D. Hypertonic saline 4 mL/kg

Answer: (A)

Early aggressive fluid resuscitation with isotonic crystalloids is the standard approach to improve intravascular volume and tissue perfusion in sepsis. The best option is giving about 30 mL/kg of isotonic crystalloid within the first 3 hours after recognizing sepsis or septic shock, typically delivered over roughly 30 to 60 minutes. This choice aligns with guideline recommendations for initial resuscitation, aiming to rapidly restore preload and perfusion while avoiding the risks and higher costs associated with other fluid types.

Colloids or blood products are not first-line for initial resuscitation in sepsis, and hypertonic saline is not preferred due to limited benefit and potential harms. If monitoring shows persistent hypotension after the bolus, additional fluids and vasoactive support are guided by reassessment.