Intravenous Fluid Therapy Choice in Trauma Patients in the Intensive Care Unit: A Scoping Review

Area of Science:

• Critical Care Medicine
• Trauma Surgery
• Fluid Resuscitation

Background:

• Intravenous fluid resuscitation in critically ill patients is debated.
• Limited evidence exists for fluid choices in trauma patients.

Purpose of the Study:

• To review current recommendations for intravenous fluid resuscitation in trauma patients.
• To assess the impact of fluid choices on patient outcomes.

Main Methods:

• Scoping review utilizing the Joanna Briggs Institute framework.
• Appraisal of 10 articles on crystalloid and colloid solutions.

Main Results:

• No significant difference in major adverse outcomes (mortality, AKI, LOS) with crystalloid types, except for TBI patients.
• Normal saline showed benefit in traumatic brain injury (TBI) patients.
• Albumin and hypertonic saline were generally safe adjuncts, except in TBI.

Conclusions:

• Balanced crystalloids and normal saline are interchangeable for trauma patients, excluding TBI.
• Albumin's use as first-line resuscitation is questionable due to cost and lack of demonstrated benefit.
• Hypertonic saline may benefit patients with delayed abdominal closure.