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Title: Defining fluid removal in the intensive care unit: A national and international survey of critical care practice.
Austin Authors: O'Connor, Michael E;Jones, Sarah L;Glassford, Neil J;Bellomo, Rinaldo ;Prowle, John R
Affiliation: Intensive Care Unit, Royal Darwin Hospital, Tiwi, Australia
Department of Intensive Care, Austin Health, Heidelberg, Victoria, Australia
Australian and New Zealand Intensive Care Research Centre, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
School of Medicine, The University of Melbourne, Melbourne, Australia
Adult Critical Care Unit, Royal London Hospital, Barts Health NHS Trust, London, UK
Critical Care and Perioperative Medicine Research Group, William Harvey Research Institute, Queen Mary University of London, London, UK
Issue Date: Nov-2017 2017-06-13
Publication information: Journal of the Intensive Care Society 2017; 18(4): 282-288
Abstract: To identify and compare how intensive care unit specialists in the United Kingdom and Australia and New Zealand self-reportedly define, assess and manage fluid overload in critically ill patients using a structured online questionnaire. We assessed 219 responses. Australia and New Zealand and United Kingdom intensive care unit specialists reported using clinical examination findings, bedside tools and radiological features to assess fluid status, diagnose fluid overload and initiate fluid removal in the critically ill. An elevated central venous pressure is not regarded as helpful in diagnosing fluid overload and targeting a clinician-set fluid balance is the most popular management strategy. Renal replacement therapy is used ahead of more diuretic therapy in patients who are oligo/anuric, or when diuretic therapy has not generated an adequate response. This self-reported account of practice by United Kingdom and Australia and New Zealand intensivists demonstrates that fluid overload remains poorly defined with variability in both management and practice.
DOI: 10.1177/1751143717699423
ORCID: 0000-0002-1650-8939
PubMed URL: 29123557
ISSN: 1751-1437
Type: Journal Article
Subjects: Fluid overload
critical care
fluid removal
renal replacement therapy
Appears in Collections:Journal articles

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