Intravenous fluid use after cardiac surgery: a multicentre, prospective, observational study

Area of Science:

• Critical Care Medicine
• Surgical Fluid Management
• Postoperative Care

Background:

• Optimal fluid replacement strategies post-major surgery are debated.
• Restrictive fluid regimens are of increasing interest.

Purpose of the Study:

• To document current fluid administration practices in patients following cardiac surgery.
• To understand the volume and frequency of fluid administration in the early postoperative period.

Main Methods:

• A multicenter, prospective observational study was conducted over 8 weeks.
• Data were collected from 235 consecutive patients across five intensive care units in Australia and New Zealand.
• Details of fluid boluses and all intravenous fluids in the first 24 hours post-ICU admission were recorded.

Main Results:

• A total of 1226 fluid boluses (average 504 mL each) were administered.
• Median total fluid for volume expansion was 2250 mL, with a median total IV intake of 4493 mL/patient in 24 hours.
• Hypotension was the primary reason for fluid bolus administration (65%), with crystalloids used in 65% of cases.

Conclusions:

• Fluid boluses constitute a substantial component of positive fluid balance in postoperative cardiac surgery patients.
• These findings highlight the need for further investigation into the impact of fluid bolus administration on patient outcomes.