Dataset Information

Resuscitation fluid use in critically ill adults: an international cross-sectional study in 391 intensive care units.

ABSTRACT:

Introduction

Recent evidence suggests that choice of fluid used for resuscitation may influence mortality in critically ill patients.

Methods

We conducted a cross-sectional study in 391 intensive care units across 25 countries to describe the types of fluids administered during resuscitation episodes. We used generalized estimating equations to examine the association between patient, prescriber and geographic factors and the type of fluid administered (classified as crystalloid, colloid or blood products).

Results

During the 24-hour study period, 1,955 of 5,274 (37.1%) patients received resuscitation fluid during 4,488 resuscitation episodes. The main indications for administering crystalloid or colloid were impaired perfusion (1,526/3,419 (44.6%) of episodes), or to correct abnormal vital signs (1,189/3,419 (34.8%)). Overall, colloid was administered to more patients (1,234 (23.4%) versus 782 (14.8%)) and during more episodes (2,173 (48.4%) versus 1,468 (32.7%)) than crystalloid. After adjusting for patient and prescriber characteristics, practice varied significantly between countries with country being a strong independent determinant of the type of fluid prescribed. Compared to Canada where crystalloid, colloid and blood products were administered in 35.5%, 40.6% and 28.3% of resuscitation episodes respectively, odds ratios for the prescription of crystalloid in China, Great Britain and New Zealand were 0.46 (95% confidence interval (CI) 0.30 to 0.69), 0.18 (0.10 to 0.32) and 3.43 (1.71 to 6.84) respectively; odds ratios for the prescription of colloid in China, Great Britain and New Zealand were 1.72 (1.20 to 2.47), 4.72 (2.99 to 7.44) and 0.39 (0.21 to 0.74) respectively. In contrast, choice of fluid was not influenced by measures of illness severity (for example, Acute Physiology and Chronic Health Evaluation (APACHE) II score).

Conclusions

Administration of resuscitation fluid is a common intervention in intensive care units and choice of fluid varies markedly between countries. Although colloid solutions are more expensive and may possibly be harmful in some patients, they were administered to more patients and during more resuscitation episodes than crystalloids were.

SUBMITTER: Finfer S

PROVIDER: S-EPMC3219291 | biostudies-literature | 2010

REPOSITORIES: biostudies-literature

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Publications

Resuscitation fluid use in critically ill adults: an international cross-sectional study in 391 intensive care units.

Finfer Simon S Liu Bette B Taylor Colman C Bellomo Rinaldo R Billot Laurent L Cook Deborah D Du Bin B McArthur Colin C Myburgh John J

Critical care (London, England) 20101015 5

<h4>Introduction</h4>Recent evidence suggests that choice of fluid used for resuscitation may influence mortality in critically ill patients.<h4>Methods</h4>We conducted a cross-sectional study in 391 intensive care units across 25 countries to describe the types of fluids administered during resuscitation episodes. We used generalized estimating equations to examine the association between patient, prescriber and geographic factors and the type of fluid administered (classified as crystalloid, ...[more]

PMID: 20950434

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Dataset Information

Resuscitation fluid use in critically ill adults: an international cross-sectional study in 391 intensive care units.

Introduction

Methods

Results

Conclusions

Publications

Resuscitation fluid use in critically ill adults: an international cross-sectional study in 391 intensive care units.

Similar Datasets

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