Haemoglobin concentration and volume of intravenous fluids in septic shock in the ARISE trial
Abstract Background Intravenous fluids may contribute to lower haemoglobin levels in patients with septic shock. We sought to determine the relationship between the changes in haemoglobin concentration and the volume of intravenous fluids administered during resuscitation from septic shock. Methods...
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doaj-a9ce508e81d649499973e7d9fc04c3f22020-11-25T02:31:02ZengBMCCritical Care1364-85352018-05-012211810.1186/s13054-018-2029-6Haemoglobin concentration and volume of intravenous fluids in septic shock in the ARISE trialMatthew J. Maiden0Mark E. Finnis1Sandra Peake2Simon McRae3Anthony Delaney4Michael Bailey5Rinaldo Bellomo6Intensive Care Unit, University Hospital Geelong, Barwon HealthIntensive Care Unit, Royal Adelaide HospitalDiscipline of Acute Care Medicine, University of AdelaideDepartment of Haematology, SA PathologyIntensive Care Unit, Royal North Shore HospitalAustralian and New Zealand Intensive Care Research Centre, Monash UniversityAustralian and New Zealand Intensive Care Research Centre, Monash UniversityAbstract Background Intravenous fluids may contribute to lower haemoglobin levels in patients with septic shock. We sought to determine the relationship between the changes in haemoglobin concentration and the volume of intravenous fluids administered during resuscitation from septic shock. Methods We performed a retrospective cohort study of patients enrolled in the Australasian Resuscitation in Sepsis Evaluation (ARISE) trial who were not transfused red blood cells (N = 1275). We determined the relationship between haemoglobin concentration, its change over time and volume of intravenous fluids administered over 6, 24 and 72 h using univariate and multivariate analysis. Results Median (IQR) haemoglobin concentration at baseline was 133 (118–146) g/L and decreased to 115 (102–127) g/L within the first 6 h of resuscitation (P < 0.001), 110 (99–122) g/L after 24 h, and 109 (97–121) g/L after 72 h. At the corresponding time points, the cumulative volume of intravenous fluid administered was 1.3 (0.7–2.2) L, 2.9 (1.8–4.3) L and 4.6 (2.7–7.1) L. Haemoglobin concentration and its change from baseline had an independent but weak association with intravenous fluid volume at each time point (R 2 < 20%, P < 0.001). After adjusting for covariates, each litre of intravenous fluid administered was associated with a change in haemoglobin concentration of − 1.0 g/L (95% CI −1.5 to −0.6, P < 0.001) at 24 h and − 1.3 g/L (− 1.6 to − 0.9, P < 0.001) at 72 h. Conclusions Haemoglobin concentration decreases during resuscitation from septic shock, and has a significant but weak association with the volume of intravenous fluids administered.http://link.springer.com/article/10.1186/s13054-018-2029-6Septic shockHaemoglobinFluidsHaemodilutionResuscitation |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Matthew J. Maiden Mark E. Finnis Sandra Peake Simon McRae Anthony Delaney Michael Bailey Rinaldo Bellomo |
spellingShingle |
Matthew J. Maiden Mark E. Finnis Sandra Peake Simon McRae Anthony Delaney Michael Bailey Rinaldo Bellomo Haemoglobin concentration and volume of intravenous fluids in septic shock in the ARISE trial Critical Care Septic shock Haemoglobin Fluids Haemodilution Resuscitation |
author_facet |
Matthew J. Maiden Mark E. Finnis Sandra Peake Simon McRae Anthony Delaney Michael Bailey Rinaldo Bellomo |
author_sort |
Matthew J. Maiden |
title |
Haemoglobin concentration and volume of intravenous fluids in septic shock in the ARISE trial |
title_short |
Haemoglobin concentration and volume of intravenous fluids in septic shock in the ARISE trial |
title_full |
Haemoglobin concentration and volume of intravenous fluids in septic shock in the ARISE trial |
title_fullStr |
Haemoglobin concentration and volume of intravenous fluids in septic shock in the ARISE trial |
title_full_unstemmed |
Haemoglobin concentration and volume of intravenous fluids in septic shock in the ARISE trial |
title_sort |
haemoglobin concentration and volume of intravenous fluids in septic shock in the arise trial |
publisher |
BMC |
series |
Critical Care |
issn |
1364-8535 |
publishDate |
2018-05-01 |
description |
Abstract Background Intravenous fluids may contribute to lower haemoglobin levels in patients with septic shock. We sought to determine the relationship between the changes in haemoglobin concentration and the volume of intravenous fluids administered during resuscitation from septic shock. Methods We performed a retrospective cohort study of patients enrolled in the Australasian Resuscitation in Sepsis Evaluation (ARISE) trial who were not transfused red blood cells (N = 1275). We determined the relationship between haemoglobin concentration, its change over time and volume of intravenous fluids administered over 6, 24 and 72 h using univariate and multivariate analysis. Results Median (IQR) haemoglobin concentration at baseline was 133 (118–146) g/L and decreased to 115 (102–127) g/L within the first 6 h of resuscitation (P < 0.001), 110 (99–122) g/L after 24 h, and 109 (97–121) g/L after 72 h. At the corresponding time points, the cumulative volume of intravenous fluid administered was 1.3 (0.7–2.2) L, 2.9 (1.8–4.3) L and 4.6 (2.7–7.1) L. Haemoglobin concentration and its change from baseline had an independent but weak association with intravenous fluid volume at each time point (R 2 < 20%, P < 0.001). After adjusting for covariates, each litre of intravenous fluid administered was associated with a change in haemoglobin concentration of − 1.0 g/L (95% CI −1.5 to −0.6, P < 0.001) at 24 h and − 1.3 g/L (− 1.6 to − 0.9, P < 0.001) at 72 h. Conclusions Haemoglobin concentration decreases during resuscitation from septic shock, and has a significant but weak association with the volume of intravenous fluids administered. |
topic |
Septic shock Haemoglobin Fluids Haemodilution Resuscitation |
url |
http://link.springer.com/article/10.1186/s13054-018-2029-6 |
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