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PurposeThe purpose of the study is to understand what clinicians believe defines fluid bolus therapy (FBT) and the expected response to such intervention.MethodsWe asked intensive care specialists in 30 countries to participate in an electronic questionnaire of their practice, definition, and expectations of FBT.ResultsWe 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.ConclusionsDespite 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 publication

DOI

10.1016/j.jcrc.2016.05.017

Type

Journal

Journal of critical care

Publication Date

10/2016

Volume

35

Pages

126 - 132

Addresses

Department of Intensive Care, Austin Hospital, Melbourne, VIC 3084, Australia; Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Prahran, VIC 3004, Australia. Electronic address: neil.glassford@austin.org.au.

Keywords

GLobal OBservational Evaluations in the ICU (GLOBE-ICU) investigators, Humans, Critical Illness, Isotonic Solutions, Fluid Therapy, Critical Care, Internet, Intensive Care Units, Global Health, Surveys and Questionnaires, Practice Patterns, Physicians', Crystalloid Solutions