J Acute Care Surg.  2020 Mar;10(1):18-24. 10.17479/jacs.2020.10.1.18.

Resuscitation Fluid Use in a Single Surgical Intensive Care Unit

• Lee YD
• Ryu JA
• Lee DS
• Park J
• Cho J
• Chung CR
• Cho YH
• Yang JH
• Suh GY
• Park CM

• KMID: 2512816
• DOI: http://doi.org/10.17479/jacs.2020.10.1.18

Abstract

Purpose
The aim of this study was to analyze the temporal change of resuscitation fluid use based on all fluids administered in a surgical intensive care unit (ICU).
Methods
The administration of resuscitation fluid to all patients admitted to a surgical ICU of a tertiary referral hospital was investigated from 2008 to 2015. The types and volumes of fluid, and laboratory data taken within 7 days after ICU admission were evaluated. Resuscitation fluids were defined as fluids infused according to stat orders, rather than routine orders.
Results
There were a total of 8,885 admissions to the ICU for 7,886 patients. The volumetric proportion of crystalloid to total resuscitation fluids increased significantly over the study period (p < 0.001; 79.6% in 2008; 93.7% in 2015). Although the proportion of 0.9% saline to crystalloids decreased, that of balanced solutions increased (p < 0.001; 29.5% in 2008; 55.6% in 2015). The use of colloids decreased from 20.4% in 2008, to 6.3% in 2015 (p < 0.001). Proportions calculated using the number of individual fluids administered revealed trends similar to those calculated using volumetric data. The amount of infused 0.9% saline was weakly correlated with the lowest blood pH and the highest serum chloride levels (ρ = -0.26 and 0.19, respectively).
Conclusion
Changes in the trends of fluid resuscitation practice were noted in a single surgical ICU over the 8-year study period. Crystalloid use increased owing to a rise in the utilization of balanced solutions with a downward trend in colloid use.

Keyword

colloids; crystalloid solutions; fluid therapy; intensive care units