Tina Maes1, Annelies Meuwissen2, Marc Diltoer3, Duc Nam Nguyen3, Mark La Meir4, Robert Wise5, Herbert Spapen3, Manu L N G Malbrain3, Elisabeth De Waele6. 1. Intensive Care Unit, University Hospital Brussels (UZB), Brussels, Belgium; Department of Anaesthesiology, University Hospital Brussels (UZB), Brussels, Belgium. Electronic address: Tina.Maes@uzbrussel.be. 2. Intensive Care Unit, University Hospital Brussels (UZB), Brussels, Belgium; Department of Internal Medicine, University Hospital Brussels (UZB), Brussels, Belgium. 3. Intensive Care Unit, University Hospital Brussels (UZB), Brussels, Belgium; Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel (VUB), Brussels, Belgium. 4. Department of Cardiac Surgery, University Hospital Brussels (UZB), Brussels, Belgium; Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel (VUB), Brussels, Belgium. 5. Pietermaritzburg Metropolitan Department of Anaesthetics, Critical Care and Pain Management, Pietermaritzburg, South Africa; Discipline of Anaesthesia and Critical Care, School of Clinical Medicine, College of Health Sciences, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa. 6. Intensive Care Unit, University Hospital Brussels (UZB), Brussels, Belgium; Department of Nutrition, University Hospital Brussels (UZB), Brussels, Belgium; Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel (VUB), Brussels, Belgium.
Abstract
INTRODUCTION: Standardized 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. METHODS: Data on intravenous and oral fluid input and output were retrospectively collected from the electronic medical files. RESULTS: Sixty 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. CONCLUSION: Postoperative 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.
INTRODUCTION: Standardized protocols are provided for maintenance and replacement fluid therapy in critically illpatients. 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. METHODS: Data on intravenous and oral fluid input and output were retrospectively collected from the electronic medical files. RESULTS: Sixty 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. CONCLUSION: Postoperative 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.