Fluid challenges in intensive care: the FENICE study: a global inception cohort study

6533b833fe1ef96bd129c1bf

RESEARCH PRODUCT

Fluid challenges in intensive care: the FENICE study: a global inception cohort study

M1 Cecconi C Hofer Jl Teboul V Pettila E Wilkman Z Molnar G Della Rocca C Aldecoa A Artigas S Jog M Sander C Spies Jy Lefrant D De Backer C Hofer Jl Teboul Jl Teboul V Pettila E Wilkman Z Molnar G Della Rocca C Aldecoa A Artigas S Jog M Sander C Spies Jy Lefrant D De Backer D De Backer S Jog D De Backer E Silva X Zhang G Ospina-tascón J Arias I Gornik J Benes A Petersen Jy Lefrant Jl Teboul C Spies M Sander M Zsolt G Della Rocca C Sprung M Koch Ab Guttormsen M Tavares V Pettilä E Wilkman M Mikaszewska-sokolewicz C Aldecoa A Artigas C Hofer J Bakker R Parke M Kirov J Wernerman F Esen M Cecconi M Cannesson D De Backer M Cecconi D De Backer M Cecconi C Hofer V Pettila Z Molnar Jy Lefrant Jl Teboul H Njimi G François G Cueto S Hockley H Ambekar Pf Laterre Mf Dujardin P Damas P Deschamps D Glorieux E Hoste M Miribung J Devriendt L Haentjens P Biston T Dugernier D De Backer P Bulpa A Dive Y Debaveye S Franck K Conde R Morsch M Ramos F Dias S Mataloun C Mendes F Silva C Grion M Knibel C Yang Z Xiangyu G Cai G Ortiz G Ospina-tascon D Yepes Londono Arcila Hf F Molina F Pereira Hf Sanchez-galvez F Benitez J Arias Ortiz M Gonzalez Rojas G Cavric E Lukic I Zykova J Benes P Freml I Satinsky P Suk I Novak M Balik P Szturz M Kratochvil M Bestle Dg Strange A Perner Bs Rasmussen J Hauge M Meldgaard V Toome E Wilkman A Kuitunen S Varila S Hovilehto A Pulkkinen O Kiviniemi M Tallgren R Laitio N Mongardon G Dhonneur Y Malledant C Lepouse M Darmon Jp Mira Jd Chiche O Joannes-boyau S Preau J Larche N Mottard Jy Lefrant C Bengler Jl Teboul L Argaud O Hamzaoui O Desebbe P Burtin J Reignier M Durand Pg Guitard P Asfar M Guillot T Boulain A Mekontso Dessap N Ducrocq K Lakhal C Gregoire M Schmauss K Zacharowski P Meybohm S Treskatsch F Bloos S Van Huelst H Baumann A Kersten A Goldmann G Gkiokas A Dimoula G Kofinas G Anthopoulos Z Molnar B Pankotai C Kopitko B Gartner E Schaffer B Fulesdi A Sarkany S Jog S Samavedam B Shah S Dixit K Toraskar S Nandakumar Ak Goila A Nayyar M Patel D Mitra B Jagiasi S Jakkinaboina J Goswami S Ghosh M Hashemian A Mahmoodpoor D Breen J Benbenishty M Kuniavsky O Kolpak G Castiglione G Monti A Molin G Martucci G Panarello G Della Rocca Sm Raineri V Pota A Acquarolo F Ploner G Lapichino A Lombardo A Roasio S Cardelino A Pignataro R Oggioni V Mangani V Parrini S Spadaro Ca Volta D Alampi S Torrente L Monastra F Marini P Mazzini D Albanese S Riccardi F Ruberto Ac Belluomo R Silvestri G Citerio N Brienza L Brazzi A Protti N Bottino A David D Manzoni G Foti F Numis H Morimatsu K Shimizu M Koch L Munster V Rai M Buttigieg P Pickkers L Mijzen J Kesecioglu J Bakker D Van Duijn P Ormskerk O Beck R Parke J Goodson B King J Koelle S Kantor O Gomez I Ramos M Mikaszewska-sokolewicz M Jedynak W Sulkowski B Adamik M Chruscikowski J Wadelek J Korzybski A Misiewska-kaczur M Piasecka-twarog A Fijaikowska D Maciejewski K Smiechowicz E Milkowska A Czerwinska A Lukaszewska A Wieczorek M Czuczwar A Czerwiec B Tamowicz V Branco J Estilita C Basilio C Diogo R Toma Si Bubenek-turconi D Filipescu M Popescu J Titova V Belskiy A Smetkin E Grigoryev S Pugachev A Gasenkampf A Abouelala G Almekhlafi E Rupnik H Garcia-delgado A Saez Fernandez M Celaya Lopez F Ramasco K Planas C Aldecoa E Zavala M De Nadal Sa Picos S Fernandez A Munoz L Herrera Para E Maseda A Rovira Monge Garcia Mi R Ferrer J Sole Violan X Garcia Nogales E Torrents J Ripolles Melchor Tomás Marsilla Ji P Araujo Aguilar G Aguilar Em Menor Mc Martinez Leal Micharet Am C Ferri Riera D Mosquera I Astola S Freita-ramos P Garcia Olivares Jimenez Bartolome Mb I Fernandez Gonzalez Ja Sanchez-izquierdo P Arribas C Gimenez-esparzavich M Anglada S Martin Rk Weerakoon J Wernerman K Bendjelid T Fumeaux C Hofer M Maggiorini O Demirkiran T Adanir P Ergin Ozcan N Kelebek Girgin N Elahi S Kashef A Alsabbah A Lowe M Wise Mp Vizcaychipi S Baht S Webb J Friis C Boulanger A Gratrix D Harvey A Ferguson L Espie P Toth-tarsoly K Lewis B Shelley J Thuerey D Przemyslaw M Ranganathan A Hormis M Spivey J Henning R Saveker P Csabi M Bland C Barrera Groba N Al-subaie R Thomson M Hamilton F Iannuccelli C Roberts N Sherwood V Kasipandian J Silversides A Jonas T Szakmany E Vickers J Richards L Tham D Williams S Heenen M Hobrok A Walden A Raj P Bauer R Kashyap P Tolnai Bj Kjelle Fh Andersen Je Palo S. A. Namendys-silva

subject

Male Soins intensifs réanimation medicine.medical_treatment Cohort Studies; Female; Humans; Male; Middle Aged; Practice Patterns Physicians'; Critical Care; Fluid Therapy; Critical Care and Intensive Care Medicine Practice Patterns ESICM Trial Group Critical Care and Intensive Care Medicine RESPONSIVENESS Cohort Studies Seven-Day Profile Publication Medicine and Health Sciences Practice Patterns Physicians'FENICE Investigators CIRCULATORY SHOCK intensive care ddc:617 RENAL REPLACEMENT THERAPY Middle Aged 3. Good health OF-THE-LITERATURE SHOCK Female lipids (amino acids peptides and proteins)Erratum intensive care fluid therapy fluids Life Sciences & Biomedicine CRITICALLY-ILL PATIENTS Human Cohort study medicine.medical_specialty Critical Care HYDROXYETHYL STARCH 130/0.4 MEDLINE 1117 Public Health and Health Services NO fluid therapy Critical Care Medicine CIRCULATORY General & Internal Medicine Intensive care Anesthesiology PATIENTS medicine cohort study Humans Renal replacement therapy Intensive care medicine intensive care; fluids; cohort study Physicians'Science & Technology CRITICALLY-ILL business.industry Septic shock SEPTIC SHOCK 1103 Clinical Sciences 3126 Surgery anesthesiology intensive care radiology medicine.disease Emergency & Critical Care Medicine ARTERIAL-PRESSURE SEVERE SEPSIS Clinical trial Fluid Therapy Observational study Cohort Studie business [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology TASK-FORCE

description

Background: Fluid challenges (FCs) are one of the most commonly used therapies in critically ill patients and represent the cornerstone of hemodynamic management in intensive care units. There are clear benefits and harms from fluid therapy. Limited data on the indication, type, amount and rate of an FC in critically ill patients exist in the literature. The primary aim was to evaluate how physicians conduct FCs in terms of type, volume, and rate of given fluid; the secondary aim was to evaluate variables used to trigger an FC and to compare the proportion of patients receiving further fluid administration based on the response to the FC. Methods: This was an observational study conducted in ICUs around the world. Each participating unit entered a maximum of 20 patients with one FC. Results: 2213 patients were enrolled and analyzed in the study. The median [interquartile range] amount of fluid given during an FC was 500 ml (500–1000). The median time was 24 min (40–60 min), and the median rate of FC was 1000 [500–1333] ml/h. The main indication for FC was hypotension in 1211 (59 %, CI 57–61 %). In 43 % (CI 41–45 %) of the cases no hemodynamic variable was used. Static markers of preload were used in 785 of 2213 cases (36 %, CI 34–37 %). Dynamic indices of preload responsiveness were used in 483 of 2213 cases (22 %, CI 20–24 %). No safety variable for the FC was used in 72 % (CI 70–74 %) of the cases. There was no statistically significant difference in the proportion of patients who received further fluids after the FC between those with a positive, with an uncertain or with a negatively judged response. Conclusions: The current practice and evaluation of FC in critically ill patients are highly variable. Prediction of fluid responsiveness is not used routinely, safety limits are rarely used, and information from previous failed FCs is not always taken into account.

year	journal	country	edition	language
2015-09-01

http://hdl.handle.net/11573/1020411