Table 4 Comparison of indication for fluid, seniority of fluid prescriber and patient characteristics present in relation to administration of crystalloid, colloid or blood by episode for 4,488 fluid resuscitation episodes in 1,955 study participants
| Â | Crystalloid | Â | Colloid | Â | Blood | Â | ||||
|---|---|---|---|---|---|---|---|---|---|---|
| Â | Given N = 1,468 | Not given N = 3,020 | P -value | Given N = 2,173 | Not given N = 2,315 | P -value | Given N = 1,249 | Not given N = 3,239 | P -value | |
Indication for fluid | Â | Â | Â | Â | Â | Â | Â | Â | Â | |
Impaired perfusion or low cardiac output, n = 1,743% (N) | 48.0 (739) | 34.3 (1,004) | < 0.001 | 41.6 (899) | 35.6 (844) | < 0.001 | 27.0 (330) | 42.7 (1,413) | < 0.001 | |
Anaemia/bleeding/coagulopathy, n = 822% (N) | 4.9 (68) | 23.1 (754) | Â | 5.5 (119) | 29.0 (703) | Â | 49.5 (717) | 3.9 (105) | Â | |
Other fluid losses, n = 131% (N) | 3.4 (49) | 2.8 (82) | Â | 2.9 (64) | 3.1 (67) | Â | 2.3 (23) | 3.2 (108) | Â | |
Unit protocol, n = 294% (N) | 5.9 (74) | 8.2 (220) | Â | 9.9 (201) | 4.9 (93) | Â | 3.8 (36) | 8.7 (258) | Â | |
Abnormal vital signs, n = 1,266% (N) | 33.5 (483) | 26.0 (783) | Â | 34.9 (751) | 21.9 (515) | Â | 8.5 (100) | 35.5 (1,166) | Â | |
Other, n = 191% (N) | 3.1 (44) | 5.3 (147) | Â | 5.8 (117) | 3.3 (74) | Â | 2.9 (32) | 5.2 (159) | Â | |
Fluid prescriber | Â | Â | Â | Â | Â | Â | Â | Â | Â | |
ICU Specialist/consultant, n = 1,495% (N) | 35.0 (482) | 36.3 (1,013) | < 0.001 | 35.2 (690) | 36.6 (805) | 0.2 | 40.3 (486) | 34.3 (1,009) | < 0.001 | |
ICU Registrar, n = 1,368% (N) | 27.1 (353) | 31.7 (1,015) | Â | 30.9 (710) | 29.6 (658) | Â | 30.2 (395) | 30.3 (973) | Â | |
ICU Resident/junior staff, n = 1,063% (N) | 21.4 (431) | 20.5 (632) | Â | 21.4 (497) | 20.2 (566) | Â | 19.9 (235) | 21.1 (828) | Â | |
Other, n = 562% (N) | 14.6 (202) | 11.9 (360) | Â | 12.5 (276) | 13.0 (286) | Â | 10.8 (133) | 13.5 (429) | Â | |
Cardiac failure | SOFA < 3, n = 2,973% (N) | Â | Â | 0.1 | Â | Â | 0.08 | Â | Â | 0.2 |
| Â | SOFA 3+, n = 1,443% (N) | 25.6 (459) | 27.9 (984) | Â | 27.6 (706) | 26.6 (737) | Â | 28.0 (429) | 26.8 (1014) | Â |
Respiratory failure | SOFA < 3, n = 2,793% (N) | Â | Â | 0.01 | Â | Â | 0.02 | Â | Â | 0.1 |
| Â | SOFA 3+, n = 1,471% (N) | 31.4 (420) | 34.6 (1,051) | Â | 34.7 (774) | 32.4 (697) | Â | 34.8 (436) | 33.2 (1035) | Â |
Renal replacement therapy | No, n = 4,048% (N) | Â | Â | 0.02 | Â | Â | 0.3 | Â | Â | < 0.001 |
| Â | Yes, n = 417% (N) | 8.7 (103) | 10.2 (314) | Â | 9.5 (233) | 10.1 (184) | Â | 10.9 (175) | 9.3 (242) | Â |
Mechanical ventilation | No, n = 1,568% (N) | Â | Â | 0.04 | Â | Â | 0.1 | Â | Â | 0.02 |
| Â | Yes, n = 2,907% (N) | 60.5 (910) | 62.8 (1,997) | Â | 62.9 (1,438) | 61.2 (1,469) | Â | 63.5 (845) | 61.5 (2,062) | Â |
Low filling pressure** | No, n = 1,448% (N) | Â | Â | 0.001 | Â | Â | 0.8 | Â | Â | 0.1 |
| Â | Yes, n = 1,277% (N) | 52.7 (430) | 45.7 (847) | Â | 47.6 (652) | 47.7 (625) | Â | 45.9 (331) | 48.3 (946) | Â |
Metabolic acidosis** | No, n = 3,062% (N) | Â | Â | 0.02 | Â | Â | 0.7 | Â | Â | 0.9 |
| Â | Yes, n = 800% (N) | 18.8 (279) | 17.3 (521) | Â | 17.4 (372) | 18.0 (428) | Â | 17.5 (243) | 17.8 (557) | Â |
Lactate (mmol/L)** | < 2, n = 1,851% (N) | Â | Â | 0.3 | Â | Â | 0.6 | Â | Â | 0.07 |
| Â | 2+, n = 1,222% (N) | 37.0 (441) | 36.5 (781) | Â | 36.9 (554) | 36.5 (668) | Â | 37.2 (391) | 36.5 (831) | Â |
Heart rate (mean, b/min) | 95 | 94 | 0.07 | 94 | 94 | 0.8 | 93 | 94 | 0.9 | |
Mean arterial pressure (mean, mmHg) | 76 | 77 | 0.3 | 75 | 78 | < 0.001 | 79 | 76 | < 0.001 | |
Haemoglobin (mean, g/L) | 100 | 97 | < 0.001 | 100 | 96 | < 0.001 | 92 | 100 | < 0.001 | |
Creatinine (mean, umol/L) | 148 | 142 | 0.06 | 141 | 147 | 0.002 | 146 | 143 | 0.2 | |
Bilirubin** (mean, umol/L) | 38 | 39 | 0.96 | 39 | 38 | 0.7 | 45 | 40 | 0.1 | |
Albumin** (mean, g/L) | 27 | 27 | 0.9 | 27 | 27 | 0.3 | 27 | 27 | 0.9 | |
Urine output** (mean, ml/kg/hr) | 2.0 | 1.8 | 0.1 | 1.8 | 1.8 | 0.99 | 2.0 | 1.8 | 0.02 | |
Fluid output** (mean, ml/kg/hr) | 2.9 | 2.8 | 0.9 | 2.8 | 2.8 | 0.6 | 3.1 | 2.7 | 0.008 | |