Monitoring hyperhydration during high-dose chemotherapy: body weight or fluid balance?

Area of Science:

• Nephrology
• Oncology
• Clinical Nursing

Background:

• Intravenous hyperhydration is crucial during nephrotoxic chemotherapy to prevent kidney damage.
• Current fluid balance monitoring relies on fluid input/output measurements, which are unreliable, complex, and pose occupational risks.
• Accurate fluid balance assessment is vital for managing potential fluid overload.

Purpose of the Study:

• To determine the concordance between body weight and fluid intake/output measurements.
• To evaluate the safety and clinical consequences of using only body weight for fluid overload monitoring during chemotherapy-induced hyperhydration.

Main Methods:

• Prospective cohort study design.
• Collection of 591 paired observations of fluid balances and body weights.
• Statistical analysis including Pearson correlation to assess concordance.

Main Results:

• A low Pearson correlation (r = 0.28) was observed between fluid balance and body weight.
• Body weight showed a higher increase compared to fluid balance.
• Only 4 cases (0.6%) required furosemide based on fluid input/output, with no adverse clinical outcomes if only body weight was used.

Conclusions:

• Standardized body weight measurement can be safely employed as the sole parameter for monitoring fluid retention during chemotherapy-induced hyperhydration.
• This approach offers a simpler, less labor-intensive alternative to traditional fluid input/output monitoring.
• Implementing body weight monitoring can enhance patient safety and reduce occupational hazards for healthcare professionals.