• Galinos Barmparas, Ara Ko, Megan Y Harada, Andrea A Zaw, Jason S Murry, Eric J T Smith, Sogol Ashrafian, Beatrice J Sun, and Eric J Ley.
• Division of Trauma and Critical Care, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA. Electronic address: Galinos.Barmparas@cshs.org.
• J Crit Care. 2016 Feb 1; 31 (1): 201-5.

PurposeThe purpose of the study is to determine if excessive fluid administration is associated with a prolonged hospital course and worse outcomes.Materials And MethodsIn July 2013, all normotensive trauma patients admitted to the surgical intensive care unit (ICU) were administered crystalloids at 30 mL/h ("to keep open [TKO]") and were compared to patients admitted during the preceding 6 months who were placed on a rate between 125 mL/h to 150 mL/h (non-TKO). The primary outcomes were ICU, hospital, and ventilator days.ResultsA total of 101 trauma patients met inclusion criteria: 56 (55.4%) in the TKO and 45 (44.6%) in the non-TKO group. Overall, the 2 groups were similar in regard to age, Injury Severity Score, Acute Physiology and Chronic Health Evaluation IV scores, and the need for mechanical ventilation. TKO had no effect on renal function compared to non-TKO with similarities in maximum hospital creatinine. TKO patients had lower ICU stay (2.7 ± 1.5 vs 4.1 ± 4.6 days; P = .03) and ventilator days (1.4 ± 0.5 vs 5.5 ± 4.8 days; P < .01).ConclusionsA protocol that encourages admission basal fluid rate of TKO or 30 mL/h in normotensive trauma patients is safe, reduces fluid intake, and may be associated with a shorter intensive care unit course and fewer ventilator days.Copyright © 2015 Elsevier Inc. All rights reserved.

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