• Frédérique Schortgen, Cécilia Tabra Osorio, Dorothée Carpentier, Matthieu Henry, Pascal Beuret, Guillaume Lacave, Georges Simon, Pierre-Yves Blanchard, Tiphanie Gobe, Antoine Guillon, Laurent Bitker, Guillaume Duhommet, QuenotJean-PierreJPDepartment of Intensive Care, Burgundy University Hospital, Dijon, France.Lipness Team, INSERM Research Center LNC-UMR1231 and LabEx LipSTIC, University of Burgundy, Dijon, France.INSERM CIC 1432, Clinical Epidemiology, University of Bu, Matthieu Le Meur, Sébastien Jochmans, Fabrice Dubouloz, Nolwenn Mainguy, Josselin Saletes, Thibault Creutin, Pierre Nicolas, Julien Senay, Anne-Lise Berthelot, Delphine Rizk, David Tran Van, Audrey Riviere, Sarah Beatrice Heili-Frades, Justine Nunes, Nadine Robquin, Sylvie Lhotellier, Stanislas Ledochowski, Armelle Guénégou-Arnoux, Adrien Constan, and Save Useless Fluids For Intensive Resuscitation (SUFFIR) Study Group, Reseau European de Recherche en Ventilation Artificielle (REVA) Network.
• Réanimation et surveillance continue adulte, Centre hospitalier intercommunal, Créteil, France.
• Crit. Care Med. 2024 Feb 1; 52 (2): 258267258-267.

ObjectivesPatients at risk of adverse effects related to positive fluid balance could benefit from fluid intake optimization. Less attention is paid to nonresuscitation fluids. We aim to evaluate the heterogeneity of fluid intake at the initial phase of resuscitation.DesignProspective multicenter cohort study.SettingThirty ICUs across France and one in Spain.PatientsPatients requiring vasopressors and/or invasive mechanical ventilation.InterventionsNone.Measurements And Main ResultsAll fluids administered by vascular or enteral lines were recorded over 24 hours following admission and were classified in four main groups according to their predefined indication: fluids having a well-documented homeostasis goal (resuscitation fluids, rehydration, blood products, and nutrition), drug carriers, maintenance fluids, and fluids for technical needs. Models of regression were constructed to determine fluid intake predicted by patient characteristics. Centers were classified according to tertiles of fluid intake. The cohort included 296 patients. The median total volume of fluids was 3546 mL (interquartile range, 2441-4955 mL), with fluids indisputably required for body fluid homeostasis representing 36% of this total. Saline, glucose-containing high chloride crystalloids, and balanced crystalloids represented 43%, 27%, and 16% of total volume, respectively. Whatever the class of fluids, center of inclusion was the strongest factor associated with volumes. Compared with the first tertile, the difference between the volume predicted by patient characteristics and the volume given was +1.2 ± 2.0 L in tertile 2 and +3.0 ± 2.8 L in tertile 3.ConclusionsFluids indisputably required for body fluid homeostasis represent the minority of fluid intake during the 24 hours after ICU admission. Center effect is the strongest factor associated with the volume of fluids. Heterogeneity in practices suggests that optimal strategies for volume and goals of common fluids administration need to be developed.Copyright © 2023 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved.

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