Defining the characteristics and expectations of fluid bolus therapy: A worldwide perspective

Neil J. Glassford, Johan Mårtensson, Glenn M. Eastwood, Sarah L. Jones, Aiko Tanaka, Erica Wilkman, Michael Bailey, Rinaldo Bellomo, Yaseen Arabi, Sean M. Bagshaw, Jonathan Bannard-Smith, Du Bin, Arnaldo Dubin, Jacques Duranteau, Jorge Echeverri, Eric Hoste, Michael Joannidis, Kianoush Kashani, John Kellum, Atul P. KulkarniGiovanni Landoni, Christina Lluch Candal, Martin Matejovic, Nor'azim Modh Yunos, Alistair Nichol, Heleen Oudemans van Straaten, Anders Perner, Ville Pettila, Jason Phua, Glenn Hernandez, Alex Puxty, Konrad Reinhart, Guy Richards, Antoine Schneider, Isabella Tsuji, Shigehiko Uchino

Research output: Contribution to journalArticle

Abstract

Purpose The purpose of the study is to understand what clinicians believe defines fluid bolus therapy (FBT) and the expected response to such intervention. Methods We asked intensive care specialists in 30 countries to participate in an electronic questionnaire of their practice, definition, and expectations of FBT. Results We obtained 3138 responses. Despite much variation, more than 80% of respondents felt that more than 250 mL of either colloid or crystalloid fluid given over less than 30 minutes defined FBT, with crystalloids most acceptable. The most acceptable crystalloid and colloid for use as FBT were 0.9% saline and 4% albumin solution, respectively. Most respondents believed that one or more of the following physiological changes indicates a response to FBT: a mean arterial pressure increase greater than 10 mm Hg, a heart rate decrease greater than 10 beats per minute, an increase in urinary output by more than 10 mL/h, an increase in central venous oxygen saturation greater than 4%, or a lactate decrease greater than 1 mmol/L. Conclusions Despite wide variability between individuals and countries, clear majority views emerged to describe practice, define FBT, and identify a response to it. Further investigation is now required to describe actual FBT practice and to identify the magnitude and duration of the physiological response to FBT and its relationship to patient-centered outcomes.

Original languageEnglish
Pages (from-to)126-132
Number of pages7
JournalJournal of Critical Care
Volume35
DOIs
Publication statusPublished - Oct 1 2016

Keywords

  • Critical care
  • Fluid bolus therapy
  • Fluid resuscitation
  • Hemodynamic optimization

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

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    Glassford, N. J., Mårtensson, J., Eastwood, G. M., Jones, S. L., Tanaka, A., Wilkman, E., Bailey, M., Bellomo, R., Arabi, Y., Bagshaw, S. M., Bannard-Smith, J., Bin, D., Dubin, A., Duranteau, J., Echeverri, J., Hoste, E., Joannidis, M., Kashani, K., Kellum, J., ... Uchino, S. (2016). Defining the characteristics and expectations of fluid bolus therapy: A worldwide perspective. Journal of Critical Care, 35, 126-132. https://doi.org/10.1016/j.jcrc.2016.05.017