Mansoori JN, et al. - By performing a retrospective outcome analysis including mechanically ventilated patients admitted to intensive care units, researchers assessed usual care variability as well as inquired about the differential influence of observed and predicted fluid resuscitation volumes on risk-adjusted hospital mortality for mechanically ventilated patients in shock. They used the 2013 Premier Hospital Database. They found a link between highly variable day 1 fluid resuscitation and a non-uniform influence on risk-adjusted hospital mortality among different subgroups of mechanically ventilated patients with shock. Among all shock patients and in a subgroup of shock patients having comorbid conditions predictive of lower fluid volume administration, increased risk-adjusted hospital mortality was observed in relation to greater-than-expected fluid resuscitation vs patients that were administered expected (± 1.5 L predicted) day 1 fluid volumes. Hence, fluid resuscitation strategies incorporating broadly applied fluid volume targets in the early phase of shock resuscitation deserve a closer evaluation.