Category: Critical Care
Keywords: IVF, intravenous fluids, resuscitation, infusion rates (PubMed Search)
-- Unblinded, randomized
-- 10,520 patients clinically requiring a fluid challenge, from 75 ICUs in Brazil
-- Infusion rate 333 mL/hr vs 999 mL/hr
* (Trial also compared plasmalyte vs 0.9% saline, analyzed in separate study)
-- Some notable exclusion criteria: severe hypo/hypernatremia, AKI or expected to need RRT 6 hrs after admission
* Faster infusion rates allowed at physician discretion in patients with active bleeding or severe hypotension (SBP < 80 or MAP < 50 mmHg); patient was returned to assigned rate after condition resolved
* Almost 1/2 the patients received at least 1L of IVF in 24 hours prior to enrollment
-- Results: No sig difference in 90-day survival, use of RRT, AKI, mechanical ventilator free days, ICU/hospital mortality/LOS
Bottom Line: There is not yet compelling evidence that there are differences in patient outcomes in patients receiving fluid boluses given at 333 cc/hr vs. 999 cc/hr.
1. Zampieri FG, Machado FR, Biondi RS, et al. Effect of slower vs faster intravenous fluid bolus rates on mortality in critically ill patients: the basics randomized clinical trial. JAMA. Published online August 10, 2021.doi:10.1001/jama.2021.11444
2. Zampieri FG, Machado FR, Biondi RS, et al. Effect of intravenous fluid treatment with a balanced solution vs 0. 9% saline solution on mortality in critically ill patients: the basics randomized clinical trial. JAMA. Published online August 10, 2021.