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Table 5 Multivariate analysis of factors associated with the use of crystalloid, colloid or blood for fluid resuscitation episodes*

From: Resuscitation fluid use in critically ill adults: an international cross-sectional study in 391 intensive care units

 

OR (95%CI) crystalloid given

 

OR (95%CI) colloid given

 

OR (95%CI) blood given

 

Characteristic

 

P -value

 

P -value

 

P -value

Age (per one year increase)

1.00 (0.99 to 1.00)

 

1.00 (1.00 to 1.01)

 

1.00 (0.99 to 1.01)

 

Study region

      

Canada

1.00

 

1.00

 

1.00

 

Australia

0.69 (0.42 to 1.11)

 

1.33 (0.88 to 2.02)

 

1.79 (1.00 to 3.23)

 

China

0.46 (0.30 to 0.69)

< 0.001

1.72 (1.20 to 2.47)

0.003

3.33 (2.02 to 5.50)

< 0.001

Denmark

0.50 (0.27 to 0.94)

 

1.43 (0.83 to 2.48)

 

4.09 (2.03 to 8.25)

< 0.001

France

1.60 (0.96 to 2.66)

 

0.82 (0.51 to 1.32)

 

0.88 (0.43 to 1.78)

 

Germany

1.62 (1.08 to 2.44)

 

0.79 (0.54 to 1.14)

 

1.07 (0.62 to 1.84)

 

Great Britain

0.18 (0.10 to 0.32)

< 0.001

4.72 (2.99 to 7.44)

< 0.001

0.93 (0.51 to 1.73)

 

Hong Kong

0.88 (0.44 to 1.74)

 

0.93 (0.51 to 1.72)

 

1.17 (0.47 to 2.93)

 

Italy

2.06 (1.28 to 3.31)

0.003

1.33 (0.86 to 2.06)

 

1.10 (0.59 to 2.03)

 

New Zealand

3.43 (1.71 to 6.84)

< 0.001

0.39 (0.21 to 0.74)

0.004

0.48 (0.19 to 1.24)

 

Sweden

0.43 (0.23 to 0.80)

0.008

1.67 (0.99 to 2.82)

 

4.99 (2.58 to 9.63)

< 0.001

Switzerland

0.96 (0.48 to 1.92)

 

1.12 (0.60 to 2.10)

 

1.18 (0.49 to 2.82)

 

USA

2.55 (1.36 to 4.79)

0.004

0.16 (0.08 to 0.33)

< 0.001

3.81 (1.78 to 8.17)

0.001

Other European

1.01 (0.59 to 1.72)

 

1.26 (0.77 to 2.05)

 

2.27 (1.17 to 4.39)

 

Other countries

2.52 (1.46 to 4.33)

0.001

0.53 (0.32 to 0.89)

 

1.43 (0.70 to 2.93)

 

Admission source

      

Operating room after elective surgery

1.00

 

1.00

 

1.00

 

Hospital floor

1.26 (0.91 to 1.75)

 

1.05 (0.80 to 1.38)

 

0.59 (0.41 to 0.84)

0.003

Transfer from other ICU or hospital

1.49 (1.03 to 2.15)

 

0.80 (0.58 to 1.11)

 

0.60 (0.39 to 0.91)

 

Operating room after emergency surgery

1.57 (1.12 to 2.20)

0.008

0.93 (0.69 to 1.24)

 

0.58 (0.39 to 0.86)

0.006

Emergency room

2.16 (1.56 to 2.99)

< 0.001

0.67 (0.50 to 0.90)

0.008

0.50 (0.34 to 0.75)

0.001

Hospital floor after previous ICU stay

1.12 (0.75 to 1.67)

 

1.18 (0.83 to 1.67)

 

0.62 (0.39 to 0.99)

 

Trauma at hospital admission

      

No trauma

1.00

 

1.00

 

1.00

 

Trauma without brain injury

0.93 (0.64 to 1.35)

 

1.02 (0.73 to 1.42)

 

1.26 (0.82 to 1.95)

 

Trauma with brain injury

1.13 (0.69 to 1.84)

 

1.05 (0.68 to 1.64)

 

1.15 (0.63 to 2.08)

 

Sepsis in 24 hrs prior to survey date

      

No sepsis

1.00

 

1.00

 

1.00

 

Sepsis

0.90 (0.71 to 1.15)

 

1.26 (1.02 to 1.55)

 

0.67 (0.51 to 0.89)

0.005

Number of days in ICU at survey date

      

0 days

1.00

 

1.00

 

1.00

 

> 0 days

0.70 (0.56 to 0.87)

0.001

1.28 (1.05 to 1.56)

 

0.91 (0.70 to 1.19)

 

Indication for fluid

      

Impaired perfusion or low cardiac output

1.00

 

1.00

 

1.00

 

Anaemia/bleeding/coagulopathy

0.15 (0.12 to 0.20)

< 0.001

0.13 (0.10 to 0.17)

< 0.001

26.7 (20.2 to 35.4)

< 0.001

Other fluid losses

0.90 (0.60 to 1.37)

 

0.83 (0.55 to 1.23)

 

0.90 (0.54 to 1.49)

 

Unit protocol

0.72 (0.52 to 1.01)

 

1.65 (1.21 to 2.25)

0.002

0.44 (0.29 to 0.67)

< 0.001

Abnormal vital signs

0.93 (0.78 to 1.11)

 

1.34 (1.12 to 1.60)

0.001

0.34 (0.25 to 0.44)

< 0.001

Other

0.39 (0.26 to 0.59)

< 0.001

1.70 (1.18 to 2.45)

0.004

0.74 (0.47 to 1.18)

 

Fluid prescriber

      

ICU Specialist/consultant

1.00

 

1.00

 

1.00

 

ICU Registrar

0.88 (0.71 to 1.09)

 

1.10 (0.90 to 1.34)

 

0.83 (0.64 to 1.08)

 

ICU Resident/junior staff

1.19 (0.95 to 1.49)

 

1.04 (0.83 to 1.29)

 

0.72 (0.53 to 0.96)

 

Other

1.36 (1.05 to 1.76)

 

1.12 (0.87 to 1.45)

 

0.60 (0.42 to 0.85)

0.004

Cardiovascular dysfunction

      

SOFA < 3

1.00

 

1.00

 

1.00

 

SOFA 3 to 4

0.94 (0.77 to 1.14)

 

1.08 (0.89 to 1.29)

 

1.26 (0.99 to 1.61)

 

Respiratory failure

      

SOFA < 3

1.00

 

1.00

 

1.00

 

SOFA 3 to 4

0.87 (0.72 to 1.06)

 

1.10 (0.92 to 1.33)

 

1.02 (0.80 to 1.31)

 

Renal replacement therapy

      

No

1.00

 

1.00

 

1.00

 

Yes

0.81 (0.59 to 1.11)

 

0.81 (0.60 to 1.08)

 

1.86 (1.29 to 2.68)

0.001

Mechanical ventilation

      

No

1.00

 

1.00

 

1.00

 

Yes

0.91 (0.75 to 1.12)

 

1.02 (0.85 to 1.23)

 

1.32 (1.02 to 1.71)

 

Low filling pressure

      

No

1.00

 

1.00

 

1.00

 

Yes

1.26 (1.02 to 1.55)

 

0.86 (0.70 to 1.05)

 

1.08 (0.83 to 1.40)

 

Heart rate (per 10 b/min increase)

1.05 (1.01 to 1.09)

 

0.98 (0.95 to 1.02)

 

1.01 (0.96 to 1.06)

 

Mean arterial pressure

0.97 (0.93 to 1.02)

 

1.16 (1.11 to 1.21)

< 0.001

0.85 (0.80 to 0.91)

< 0.001

(per 10 mmHg decrease)

      

Haemoglobin (per 10 g/L decrease)

0.97 (0.93 to 1.01)

 

0.94 (0.91 to 0.98)

0.004

1.24 (1.18 to 1.30)

< 0.001

% 100+

1.00

 

1.00

 

1.00

 

% 80 to 99

0.91 (0.75 to 1.10)

 

0.92 (0.77 to 1.10)

 

1.80 (1.39 to 2.31)

< 0.001

% 70 to 79

0.72 (0.54 to 0.98)

 

0.89 (0.68 to 1.18)

 

3.24 (2.29 to 4.57)

< 0.001

% < 70

0.75 (0.52 to 1.09)

 

0.60 (0.43 to 0.84)

0.004

5.74 (3.84 to 8.58)

< 0.001

Creatinine

      

(per 10 umol/L increase)

1.00 (1.00 to 1.01)

 

1.00 (0.99 to 1.00)

 

1.00 (1.00 to 1.01)

 

< 170 umol/L

1.00

 

1.00

 

1.00

 

170+umol/L

0.86 (0.66 to 1.11)

 

1.00 (0.79 to 1.26)

 

1.22 (0.91 to 1.63)

 

Chronic health points immunocompromised

     

No

1.00

 

1.00

 

1.00

 

Yes

0.64 (0.44 to 0.93)

 

1.32 (0.96 to 1.83)

 

0.96 (0.64 to 1.45)

 

APACHE II 24 hrs prior to fluid administration

     

per 1 point increase in score

1.01 (1.00 to 1.03)

 

0.99 (0.98 to 1.01)

 

1.01 (0.99 to 1.02)

 

< 16

1.00

 

1.00

 

1.00

 

16+

1.13 (0.91 to 1.41)

 

0.88 (0.72 to 1.07)

 

1.30 (1.00 to 1.68)

 

Lactate** (mmol/L)

      

< 2

1.00

 

1.00

 

1.00

 

2+

1.02 (0.82 to 1.26)

 

0.90 (0.74 to 1.11)

 

1.59 (1.21 to 2.08)

0.001

Urine output** (ml/kg/hr)

      

per ml/kg/hr

1.03 (1.00 to 1.06)

 

1.03 (0.99 to 1.06)

 

0.98 (0.93 to 1.02)

 

< 0.5

1.00

 

1.00

 

1.00

 

0.5+

0.89 (0.72 to 1.09)

 

1.10 (0.89 to 1.35)

 

1.03 (0.77 to 1.38)

 

Total fluid output** (ml/kg/hr)

      

per ml/kg/hr

1.01 (0.99 to 1.02)

 

1.01 (0.99 to 1.03)

 

1.01 (0.98 to 1.03)

 

< 1

1.00

 

1.00

 

1.00

 

1+

1.17 (0.95 to 1.43)

 

1.03 (0.85 to 1.24)

 

1.02 (0.79 to 1.33)

 
  1. P-values highlighted where < 0.01
  2. Analyses include 4,430 episodes and 1939 study participants as data were lost due to missing values which could not be included in the multivariate analysis due to small numbers in cells. This number represents a loss of 1.5% of episodes and 1.1% of study participants.
  3. **Variables have > 10% missing values