Rationale: Patients with severe sepsis without shock or tissue hypoperfusion face substantial mortality; however, treatment guidelines are lacking.Objectives: To evaluate the association between intravenous fluid resuscitation, lactate clearance, and mortality in patients with "intermediate" lactate values of 2 mmol/L or greater and less than 4 mmol/L.Measurements and Main Results: This was a retrospective study of 9,190 patients with sepsis with intermediate lactate values. Interval changes between index lactate values and those at 4, 8, and 12 hours were calculated with corresponding weight-based fluid volumes. Outcomes included lactate change and mortality. Repeat lactate tests were completed in 94.7% of patients within 12 hours.
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