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KMID : 1033220200100010018
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Journal of Acute Care Surgery
2020 Volume.10 No. 1 p.18 ~ p.24
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Resuscitation Fluid Use in a Single Surgical Intensive Care Unit
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Lee Yong-Dae
Ryu Jeong-Am
Lee Dae-Sang
Park Jin-Kyeong
Cho Joong-Bum
Chung Chi-Ryang
Cho Yang-Hyun
Yang Jeong-Hoon
Suh Gee-Young
Park Chi-Min
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Abstract
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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.
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KEYWORD
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colloids, crystalloid solutions, fluid therapy, intensive care units
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