FISSH Study

Fluids in Sepsis and Septic Shock (FISSH)


Inclusion Criteria

Patients who meet ALL of the following:

1. Patients > 16 years of age

2. Are either receiving vasoactive medications (or you will start vasoactive medications) for shock

3. Clinical suspicion of septic shock (If you are starting antibiotics “just in case”, this is good enough

4. Are within 6 hours of either:

a. presentation to Emergency Room

b. CCOT Call.

Exclusion Criteria

Patients who meet NONE of the following:

1. New intracranial bleed 

2. >10% of body surface area acute burn injury; 

3. Co-existing hemorrhagic shock (bleeding/hemorrhage as likely cause of hypotension); 

4. An imminent plan to palliate patient 

5. Receiving acute or chronic dialysis at the time of enrollment

6. Admission to ICU directly from the OR/PACU or transferred from another hospital

7.     Previous enrollment into FISSH Study

How can YOU help? 

Step 1: Identify whether patient may be eligible for FISSH and notify study PIs Marat Slessarev or John Basmaji 

Step 2: If eligible, wheel cart over to the bedside they are in in B2-179 (near Bay 5) in the back of the room

 Equipment Storage B2-179 (near Bay 5)

FISSH Cart

Step 4: Put in orders on Powerchart for Maintenance (IV Continuous) and Bolus study fluid. Do this regardless of whether you are giving bolus or maintenance.

Step 5: After signing the order, notify nurse to switch over maintenance and bolus fluids to the study fluid.

Study Summary & Documents

Research question: In patients with septic shock, what is the impact of administering 0.9% Normal Saline versus Ringer’s Lactate on 30-day mortality and other patient important outcomes including acute kidney injury, need for advanced life support, and ICU/hospital length of stay? 


This is a multi-centre stratified concealed and blinded RCT with a primary outcome of 30-day mortality with a plan to enrol 1096 patients.