• Journal of critical care · Feb 2019

    Observational Study

    Impact of maintenance, resuscitation and unintended fluid therapy on global fluid load after elective coronary artery bypass surgery.

    • Tina Maes, Annelies Meuwissen, Marc Diltoer, Duc Nam Nguyen, Mark La Meir, Robert Wise, Herbert Spapen, Malbrain Manu L N G MLNG Intensive Care Unit, University Hospital Brussels (UZB), Brussels, Belgium; Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel (VUB), B, and Elisabeth De Waele.
    • Intensive Care Unit, University Hospital Brussels (UZB), Brussels, Belgium; Department of Anaesthesiology, University Hospital Brussels (UZB), Brussels, Belgium. Electronic address: Tina.Maes@uzbrussel.be.
    • J Crit Care. 2019 Feb 1; 49: 129-135.

    IntroductionStandardized protocols are provided for maintenance and replacement fluid therapy in critically ill patients. However, unintended fluid sources (analgesics, antibiotics and other drugs) are not always taken into account when prescribing intravenous fluid therapy. We evaluated the extent to which maintenance, resuscitation and unintended fluids contributed to total fluid load in elective coronary artery bypass graft patients during their ICU stay.MethodsData on intravenous and oral fluid input and output were retrospectively collected from the electronic medical files.ResultsSixty patients were included. Maintenance fluids represented 1435 ± 570mL (49%) and 2214 ± 657mL (71%), resuscitation fluids 847 ± 542mL (29%) and 338 ± 559mL (11%), unintended fluids 639 ± 162mL (22%) and 576 ± 285mL (18%) respectively on day 1 and day 2. Mean oral intake increased almost fourfold (from 258mL to 1017mL) on the second day.ConclusionPostoperative maintenance and resuscitation fluids are responsible for most of the observed total fluid load on the first two days after elective coronary artery bypass graft surgery. Unintended fluid load is underestimated and has to be taken into account during fluid prescription.Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

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