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Previous Volume 356:1178-1182 March 15, 2007 Number 11 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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To the Editor: The review by Russell (Oct. 19 issue)¹ recommends the protocol used by Rivers et al.² and adopted in the Surviving Sepsis Campaign guidelines³ for the initial resuscitation in severe sepsis. Although others⁴ have warned against the use of this protocol, this warning did not receive the attention we think it deserves. Estimates of intravascular volume based on any given level of filling pressure do not reliably predict the response to fluid administration. In addition, patients with sepsis have characteristically high central venous oxygen saturation because of decreased oxygen extraction. The initial mean central venous oxygen saturation of . . . [Full Text of this Article]

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