Resuscitation fluid practices in Brazilian intensive care units: a secondary analysis of Fluid-TRIPS

Flavio Geraldo Rezende de Freitas Naomi Hammond Yang Li Luciano Cesar Pontes de Azevedo Alexandre Biasi Cavalcanti Leandro Taniguchi André Gobatto André Miguel Japiassú Antonio Tonete Bafi Bruno Franco Mazza Danilo Teixeira Noritomi Felipe Dal-Pizzol Fernando Bozza Jorge Ibrahin Figueira Salluh Glauco Adrieno Westphal Márcio Soares Murillo Santucci César de Assunção Thiago Lisboa Suzana Margarete Ajeje Lobo Achilles Rohlfs Barbosa Adriana Fonseca Ventura Ailson Faria de Souza Alexandre Francisco Silva Alexandre Toledo Aline Reis Allan Cembranel Alvaro Rea Neto Ana Lúcia Gut Ana Patricia Pierre Justo Ana Paula Santos André Campos D. de Albuquerque André Scazufka Antonio Babo Rodrigues Bruno Bonaccorsi Fernandino Bruno Goncalves Silva Bruno Sarno Vidal Bruno Valle Pinheiro Bruno Vilela Costa Pinto Carlos Augusto Ramos Feijo Carlos de Abreu Filho Carlos Eduardo da Costa Nunes Bosso Carlos Eduardo Nassif Moreira Carlos Henrique Ferreira Ramos Carmen Tavares Cidamaiá Arantes Cintia Grion Ciro Leite Mendes Claudio Kmohan Claudio Piras Cristine Pilati Pileggi Castro Cyntia Lins Daniel Beraldo Daniel Fontes Daniela Boni Débora Castiglioni Denise de Moraes Paisani Durval Ferreira Fonseca Pedroso Ederson Roberto Mattos Edgar de Brito Sobrinho Edgar M. V. Troncoso Edison Moraes Rodrigues Filho Eduardo Enrico Ferrari Nogueira Eduardo Leme Ferreira Eduardo Souza Pacheco Euzebio Jodar Evandro L. A. Ferreira Fabiana Fernandes de Araujo Fabiana Schuelter Trevisol Fábio Ferreira Amorim Fabio Poianas Giannini Fabrício Primitivo Matos Santos Fátima Buarque Felipe Gallego Lima Fernando Antonio Alvares da Costa Fernando Cesar dos Anjos Sad Fernando G. Aranha Fernando Ganem Flavio Callil Francisco Flávio Costa Filho Frederico Toledo Campo Dall´Arto Geovani Moreno Gilberto Friedman Giulliana Martines Moralez Guilherme Abdalla da Silva Guilherme Costa Guilherme Silva Cavalcanti Guilherme Silva Cavalcanti Gustavo Navarro Betônico Gustavo Navarro Betônico Hélder Reis Helia Beatriz N. Araujo Helio Anjos Hortiz Júnior Helio Penna Guimaraes Hugo Urbano Israel Maia Ivan Lopes Santiago Filho Jamil Farhat Júnior Janu Rangel Alvarez Joel Tavares Passos Jorge Eduardo da Rocha Paranhos José Aurelio Marques José Gonçalves Moreira Filho Jose Neto Andrade José Onofre de C Sobrinho Jose Terceiro de Paiva Bezerra Juliana Apolônio Alves Juliana Ferreira Jussara Gomes Karina Midori Sato Karine Gerent Kathia Margarida Costa Teixeira Katia Aparecida Pessoa Conde Laércia Ferreira Martins Lanese Figueirêdo Leila Rezegue Leonardo Tcherniacovsk Leone Oliveira Ferraz Liane Cavalcante Ligia Rabelo Lilian Miilher Lisiane Garcia Luana Tannous Ludhmila Abrahão Hajjar Luís Eduardo Miranda Paciência Luiz Monteiro da Cruz Neto Macia Valeria Bley Marcelo Ferreira Sousa Marcelo Lourencini Puga Marcelo Luz Pereira Romano Marciano Nobrega Marcio Arbex Márcio Leite Rodrigues Márcio Osório Guerreiro Marcone Rocha Maria Angela Pangoni Alves Maria Angela Pangoni Alves Maria Doroti Rosa Mariza D’Agostino Dias Miquéias Martins Mirella de Oliveira Miriane Melo Silveira Moretti Mirna Matsui Octavio Messender Orlando Luís de Andrade Santarém Patricio Júnior Henrique da Silveira Paula Frizera Vassallo Paulo Antoniazzi Paulo César Gottardo Paulo Correia Paulo Ferreira Paulo Torres Pedro Gabrile M. de Barros e Silva Rafael Foernges Rafael Gomes Rafael Moraes Raimundo Nonato filho Renato Luis Borba Renato V Gomes Ricardo Cordioli Ricardo Lima Ricardo Pérez López Ricardo Rath de Oliveira Gargioni Richard Rosenblat Roberta Machado de Souza Roberto Almeida Roberto Camargo Narciso Roberto Marco Roberto waltrick Rodrigo Biondi Rodrigo Figueiredo Rodrigo Santana Dutra Roseane Batista Rouge Felipe Rubens Sergio da Silva Franco Sandra Houly Sara Socorro Faria Sergio Felix Pinto Sergio Luzzi Sergio Sant’ana Sergio Sonego Fernandes Sérgio Yamada Sérgio Zajac Sidiner Mesquita Vaz Silvia Aparecida Bezerra Bezerra Tatiana Bueno Tardivo Farhat Thiago Martins Santos Tiago Smith Ulysses V. A. Silva Valnei Bento Damasceno Vandack Nobre Vicente Cés de Souza Dantas Vivian Menezes Irineu Viviane Bogado Wagner Nedel Walther Campos Filho Weidson Dantas William Viana Wilson de Oliveira Filho Wilson Martins Delgadinho Simon Finfer Flavia Ribeiro Machado About the authors

Abstract

Objective:

To describe fluid resuscitation practices in Brazilian intensive care units and to compare them with those of other countries participating in the Fluid-TRIPS.

Methods:

This was a prospective, international, cross-sectional, observational study in a convenience sample of intensive care units in 27 countries (including Brazil) using the Fluid-TRIPS database compiled in 2014. We described the patterns of fluid resuscitation use in Brazil compared with those in other countries and identified the factors associated with fluid choice.

Results:

On the study day, 3,214 patients in Brazil and 3,493 patients in other countries were included, of whom 16.1% and 26.8% (p < 0.001) received fluids, respectively. The main indication for fluid resuscitation was impaired perfusion and/or low cardiac output (Brazil: 71.7% versus other countries: 56.4%, p < 0.001). In Brazil, the percentage of patients receiving crystalloid solutions was higher (97.7% versus 76.8%, p < 0.001), and 0.9% sodium chloride was the most commonly used crystalloid (62.5% versus 27.1%, p < 0.001). The multivariable analysis suggested that the albumin levels were associated with the use of both crystalloids and colloids, whereas the type of fluid prescriber was associated with crystalloid use only.

Conclusion:

Our results suggest that crystalloids are more frequently used than colloids for fluid resuscitation in Brazil, and this discrepancy in frequencies is higher than that in other countries. Sodium chloride (0.9%) was the crystalloid most commonly prescribed. Serum albumin levels and the type of fluid prescriber were the factors associated with the choice of crystalloids or colloids for fluid resuscitation.

Keywords:
Fluid therapy; Critical care; Colloids; Crystalloid solutions; Hemodynamics; Shock

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