The volume of infusion fluids correlates with treatment outcomes in critically ill trauma patients
BackgroundAppropriate fluid management is essential in the treatment of critically ill trauma patients. Both insufficient and excessive fluid volume can be associated with worse outcomes. Intensive fluid resuscitation is a crucial element of early resuscitation in trauma; however, excessive fluid in...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-01-01
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| Series: | Frontiers in Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2022.1040098/full |
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| author | Anna Wrzosek Anna Wrzosek Tomasz Drygalski Tomasz Drygalski Jarosław Garlicki Jarosław Garlicki Jarosław Woroń Jarosław Woroń Jarosław Woroń Wojciech Szpunar Maciej Polak Jakub Droś Jakub Droś Jerzy Wordliczek Jerzy Wordliczek Renata Zajączkowska |
| author_facet | Anna Wrzosek Anna Wrzosek Tomasz Drygalski Tomasz Drygalski Jarosław Garlicki Jarosław Garlicki Jarosław Woroń Jarosław Woroń Jarosław Woroń Wojciech Szpunar Maciej Polak Jakub Droś Jakub Droś Jerzy Wordliczek Jerzy Wordliczek Renata Zajączkowska |
| author_sort | Anna Wrzosek |
| collection | DOAJ |
| description | BackgroundAppropriate fluid management is essential in the treatment of critically ill trauma patients. Both insufficient and excessive fluid volume can be associated with worse outcomes. Intensive fluid resuscitation is a crucial element of early resuscitation in trauma; however, excessive fluid infusion may lead to fluid accumulation and consequent complications such as pulmonary edema, cardiac failure, impaired bowel function, and delayed wound healing. The aim of this study was to examine the volumes of fluids infused in critically ill trauma patients during the first hours and days of treatment and their relationship to survival and outcomes.MethodsWe retrospectively screened records of all consecutive patients admitted to the intensive care unit (ICU) from the beginning of 2019 to the end of 2020. All adults who were admitted to ICU after trauma and were hospitalized for a minimum of 2 days were included in the study. We used multivariate regression analysis models to assess a relationship between volume of infused fluid or fluid balance, age, ISS or APACHE II score, and mortality. We also compared volumes of fluids in survivors and non-survivors including additional analyses in subgroups depending on disease severity (ISS score, APACHE II score), blood loss, and age.ResultsA total of 52 patients met the inclusion criteria for the study. The volume of infused fluids and fluid balance were positively correlated with mortality, complication rate, time on mechanical ventilation, length of stay in the ICU, INR, and APTT. Fluid volumes were significantly higher in non-survivors than in survivors at the end of the second day of ICU stay (2.77 vs. 2.14 ml/kg/h) and non-survivors had a highly positive fluid balance (6.21 compared with 2.48 L in survivors).ConclusionIn critically ill trauma patients, worse outcomes were associated with higher volumes of infusion fluids and a more positive fluid balance. Although fluid resuscitation is lifesaving, especially in the first hours after trauma, fluid infusion should be limited to a necessary minimum to avoid fluid overload and its negative consequences. |
| first_indexed | 2024-04-10T23:32:07Z |
| format | Article |
| id | doaj.art-b666050b08cf42a992dc33f035a788e4 |
| institution | Directory Open Access Journal |
| issn | 2296-858X |
| language | English |
| last_indexed | 2024-04-10T23:32:07Z |
| publishDate | 2023-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Medicine |
| spelling | doaj.art-b666050b08cf42a992dc33f035a788e42023-01-12T05:02:22ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2023-01-01910.3389/fmed.2022.10400981040098The volume of infusion fluids correlates with treatment outcomes in critically ill trauma patientsAnna Wrzosek0Anna Wrzosek1Tomasz Drygalski2Tomasz Drygalski3Jarosław Garlicki4Jarosław Garlicki5Jarosław Woroń6Jarosław Woroń7Jarosław Woroń8Wojciech Szpunar9Maciej Polak10Jakub Droś11Jakub Droś12Jerzy Wordliczek13Jerzy Wordliczek14Renata Zajączkowska15Department of Interdisciplinary Intensive Care, Jagiellonian University Medical College, Kraków, PolandDepartment of Anaesthesiology and Intensive Therapy, University Hospital, Kraków, PolandDepartment of Anaesthesiology and Intensive Therapy, University Hospital, Kraków, PolandDepartment of Anaesthesiology and Intensive Therapy, Jagiellonian University Medical College, Kraków, PolandDepartment of Interdisciplinary Intensive Care, Jagiellonian University Medical College, Kraków, PolandDepartment of Anaesthesiology and Intensive Therapy, University Hospital, Kraków, PolandDepartment of Interdisciplinary Intensive Care, Jagiellonian University Medical College, Kraków, PolandDepartment of Anaesthesiology and Intensive Therapy, University Hospital, Kraków, PolandDepartment of Clinical Pharmacology, Medical College, Jagiellonian University, Kraków, PolandDepartment of Anaesthesiology and Intensive Therapy, University Hospital, Kraków, PolandDepartment of Epidemiology and Population Studies, Jagiellonian University Medical College, Kraków, PolandDepartment of Anaesthesiology and Intensive Therapy, University Hospital, Kraków, PolandDoctoral School in Medical and Health Sciences, Jagiellonian University Medical College, Kraków, PolandDepartment of Interdisciplinary Intensive Care, Jagiellonian University Medical College, Kraków, PolandDepartment of Anaesthesiology and Intensive Therapy, University Hospital, Kraków, PolandDepartment of Interdisciplinary Intensive Care, Jagiellonian University Medical College, Kraków, PolandBackgroundAppropriate fluid management is essential in the treatment of critically ill trauma patients. Both insufficient and excessive fluid volume can be associated with worse outcomes. Intensive fluid resuscitation is a crucial element of early resuscitation in trauma; however, excessive fluid infusion may lead to fluid accumulation and consequent complications such as pulmonary edema, cardiac failure, impaired bowel function, and delayed wound healing. The aim of this study was to examine the volumes of fluids infused in critically ill trauma patients during the first hours and days of treatment and their relationship to survival and outcomes.MethodsWe retrospectively screened records of all consecutive patients admitted to the intensive care unit (ICU) from the beginning of 2019 to the end of 2020. All adults who were admitted to ICU after trauma and were hospitalized for a minimum of 2 days were included in the study. We used multivariate regression analysis models to assess a relationship between volume of infused fluid or fluid balance, age, ISS or APACHE II score, and mortality. We also compared volumes of fluids in survivors and non-survivors including additional analyses in subgroups depending on disease severity (ISS score, APACHE II score), blood loss, and age.ResultsA total of 52 patients met the inclusion criteria for the study. The volume of infused fluids and fluid balance were positively correlated with mortality, complication rate, time on mechanical ventilation, length of stay in the ICU, INR, and APTT. Fluid volumes were significantly higher in non-survivors than in survivors at the end of the second day of ICU stay (2.77 vs. 2.14 ml/kg/h) and non-survivors had a highly positive fluid balance (6.21 compared with 2.48 L in survivors).ConclusionIn critically ill trauma patients, worse outcomes were associated with higher volumes of infusion fluids and a more positive fluid balance. Although fluid resuscitation is lifesaving, especially in the first hours after trauma, fluid infusion should be limited to a necessary minimum to avoid fluid overload and its negative consequences.https://www.frontiersin.org/articles/10.3389/fmed.2022.1040098/fullfluid overloadfluid resuscitationcritical illnesstraumainjurypulmonary edema |
| spellingShingle | Anna Wrzosek Anna Wrzosek Tomasz Drygalski Tomasz Drygalski Jarosław Garlicki Jarosław Garlicki Jarosław Woroń Jarosław Woroń Jarosław Woroń Wojciech Szpunar Maciej Polak Jakub Droś Jakub Droś Jerzy Wordliczek Jerzy Wordliczek Renata Zajączkowska The volume of infusion fluids correlates with treatment outcomes in critically ill trauma patients Frontiers in Medicine fluid overload fluid resuscitation critical illness trauma injury pulmonary edema |
| title | The volume of infusion fluids correlates with treatment outcomes in critically ill trauma patients |
| title_full | The volume of infusion fluids correlates with treatment outcomes in critically ill trauma patients |
| title_fullStr | The volume of infusion fluids correlates with treatment outcomes in critically ill trauma patients |
| title_full_unstemmed | The volume of infusion fluids correlates with treatment outcomes in critically ill trauma patients |
| title_short | The volume of infusion fluids correlates with treatment outcomes in critically ill trauma patients |
| title_sort | volume of infusion fluids correlates with treatment outcomes in critically ill trauma patients |
| topic | fluid overload fluid resuscitation critical illness trauma injury pulmonary edema |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2022.1040098/full |
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