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https://ahro.austin.org.au/austinjspui/handle/1/12647
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DC Field | Value | Language |
---|---|---|
dc.contributor.author | Lipcsey, Miklos | en |
dc.contributor.author | Chiong, Jonathan | en |
dc.contributor.author | Subiakto, Ivan | en |
dc.contributor.author | Kaufman, Melissa A | en |
dc.contributor.author | Schneider, Antoine G | en |
dc.contributor.author | Bellomo, Rinaldo | en |
dc.date.accessioned | 2015-05-16T02:22:25Z | - |
dc.date.available | 2015-05-16T02:22:25Z | - |
dc.date.issued | 2015-03-01 | en |
dc.identifier.citation | Critical Care and Resuscitation; 17(1): 6-11 | en |
dc.identifier.govdoc | 25702756 | en |
dc.identifier.other | PUBMED | en |
dc.identifier.uri | https://ahro.austin.org.au/austinjspui/handle/1/12647 | en |
dc.description.abstract | The physiological changes associated with fluid bolus therapy (FBT) for patients with infection-associated hypotension in the emergency department (ED) are poorly understood. We describe the physiological outcomes of FBT in the first 6 hours (primary FBT) for patients presenting to the ED with infection-associated hypotension.We studied 101 consecutive ED patients with infection and a systolic blood pressure (SBP)<100 mmHg who underwent FBT in the first 6 hours.We screened 1123 patients with infection and identified 101 eligible patients. The median primary FBT volume given was 1570 mL (interquartile range, 1000- 2490 mL). The average mean arterial pressure (MAP) did not change from admission to 6 hours in the whole cohort, or in patients who were hypotensive on arrival at the ED. However, the average MAP increased from its lowest value during the first 6 hours (66 mmHg [SD, 10 mmHg]) to its value at 6 hours (73 mmHg [SD, 12 mmHg]; P<0.001). The mean heart rate, body temperature, respiratory rate and plasma creatinine level decreased (P<0.05). In patients who were severely hypotensive (SBP<90 mmHg) on arrival at the ED, the MAP increased from 54 mmHg (SD, 8 mmHg) to 70 mmHg (SD, 14 mmHg) (P<0.001). At 6 hours, however, SBP was still <100 mmHg in 44 patients and <90 mmHg in 17 patients. When noradrenaline was used, in 10 patients, hypotension was corrected in all 10 and the MAP increased from 58 mmHg (SD, 9 mmHg) to 75 mmHg (SD, 13 mmHg).Among ED patients admitted to an Australian teaching hospital with infection, hypotension was uncommon. FBT for hypotension was limited in volumes given and failed to achieve a sustained SBP of >100 mmHg in 40% of cases. In contrast, noradrenaline therapy corrected hypotension in all patients who received it. | en |
dc.language.iso | en | en |
dc.subject.other | Aged | en |
dc.subject.other | Aged, 80 and over | en |
dc.subject.other | Emergency Service, Hospital | en |
dc.subject.other | Female | en |
dc.subject.other | Fluid Therapy.methods | en |
dc.subject.other | Humans | en |
dc.subject.other | Hypotension.etiology.therapy | en |
dc.subject.other | Infection.complications | en |
dc.subject.other | Male | en |
dc.subject.other | Middle Aged | en |
dc.subject.other | Retrospective Studies | en |
dc.subject.other | Treatment Outcome | en |
dc.title | Primary fluid bolus therapy for infection-associated hypotension in the emergency department. | en |
dc.type | Journal Article | en |
dc.identifier.journaltitle | Critical Care and Resuscitation | en |
dc.identifier.affiliation | Department of Intensive Care, Austin Health, Heidelberg, Victoria, Australia | en |
dc.identifier.affiliation | Department of Cardiology, Northern Hospital, Melbourne, Victoria, Australia | en |
dc.identifier.affiliation | Department of Surgical Sciences, Hedenstierna Laboratory, Section of Anaesthesiology and Intensive Care, Uppsala University, Uppsala, Sweden | en |
dc.identifier.affiliation | Department of Adult Intensive Care, Centre Hospitalier Universitaire Vaudois, LaUSAnne, Switzerland. | en |
dc.description.pages | 6-11 | en |
dc.relation.url | https://pubmed.ncbi.nlm.nih.gov/25702756 | en |
dc.type.austin | Journal Article | en |
local.name.researcher | Bellomo, Rinaldo | |
item.grantfulltext | none | - |
item.openairetype | Journal Article | - |
item.languageiso639-1 | en | - |
item.fulltext | No Fulltext | - |
item.openairecristype | http://purl.org/coar/resource_type/c_18cf | - |
item.cerifentitytype | Publications | - |
crisitem.author.dept | Intensive Care | - |
crisitem.author.dept | Data Analytics Research and Evaluation (DARE) Centre | - |
Appears in Collections: | Journal articles |
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