Critical Illness, Fluid Therapy, Invasive Ventilation, Vasopressor Therapy
Conditions
Keywords
Fluid Therapy, Vasopressor, Resuscitation, Deresuscitation, Fluids
Brief summary
The goal of this woldwide observational study is to investigate various aspects of fluid and vasopressor therapy in critically ill invasively ventilated patients. The main questions it aims to answer are: * What is the global current practice of fluid and vasopressor therapy? * What are associations between this practice and clinical outcomes? Participating intensive care units will gather detailed information about fluid and vasopressor therapy prescribed to participants. Participating intensive care units will also gather information about participant outcomes such as duration of invasive ventilation, length of stay and mortality
Detailed description
Rationale: The worldwide practice of fluid and vasopressor therapy in critically ill invasively ventilated patients is uncertain. Indeed, it is unclear whether there is a difference in fluid and vasopressor therapy in these patients between Low- and Middle-income Countries (LMICs) and High-income Countries (HICs). Objective: To determine various aspects of fluid and vasopressor therapy in critically ill invasively ventilated patients in LMICs and HICs. Hypothesis: There is substantial worldwide variation in practice of fluid and vasopressor therapy in critically ill invasively ventilated patients. Study design: International, multicenter, observational study in critically ill invasively ventilated patients; data are captured during a predefined period per geographic region or country. Study population: Critically ill invasively ventilated patients. Nature and extent of the burden and risks associated with participation, benefit and group relatedness: Because of the observational design of the study using routinely collected data, there is no additional burden for the patient. Collection of data from ICU charts or electronic medical records systems is of no risk to the patients.
Interventions
None listed
Sponsors
Mahidol Oxford Tropical Medicine Research Unit
Amsterdam UMC, location VUmc
University Hospital, Antwerp
Academisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA)
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
16 Years to No maximum
Inclusion criteria
* Admitted to a participating intensive care unit; * Receiving invasive ventilation; and * Duration of ventilation \> 24 hours.
Exclusion criteria
* Age \< 16 years; * Patients transferred under invasive ventilation from another intensive care unit.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Composite of various aspects of fluid therapy | seven days | Including total volumes of types of fluids administered in the first three days after ICU admission and total volume of fluids infused in the first seven days of ICU admission |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Typical ICU outcomes; e.g. duration of ventilation, lengths of stay in ICU and hospital and, mortality in the ICU and hospital | 90 days | — |
| Incidence of acute respiratory distress syndrome | 7 days | — |
| Incidence of renal replacement therapy | 7 days | — |
| Incidence of need for renal replacement therapy at ICU discharge. | 90 days | — |
| Timing of start of continuous administration of vasopressors. | seven days | Timing of start of vasopressors from ICU admission in minutes per administration route (i.e. central versus peripheral) |
| Duration of vasopressor therapy | seven days | In days |
| Types of vasopressors | seven days | The type (i.e. noradrenaline, vasopressin, adrenaline) of vasopressors that are prescribed |
| Concentration of types of vasopressors | seven days | The concentration (i.e. in µg/ml) of vasopressors that are prescribed per administration route |
| Timing of start of administered diuretics. | seven days | Time between start of invasive ventilation and administration of diuretics in days |
| Duration of diuretic therapy | seven days | In days |
| Types of diuretics | seven days | The type of diuretics that are prescribed |
| Bolus or continous infusion of diuretics | seven days | — |
| Cumulative fluid balances | seven days | — |
| Daily urine output | seven days | — |
| Incidence of atrial arrythmias | 7 days | — |
Other
| Measure | Time frame | Description |
|---|---|---|
| Pre-defined subgroup analysis in patients admitted with acute respiratory distress syndrome | 90 days | All aforementioned outcomes in patients with acute respiratory distress syndrome |
| Pre-defined subgroup analysis in patients admitted with sepsis | 90 days | All aforementioned outcomes in patients with sepsis |
| Pre-defined subgroup analysis in patients admitted with burns | 90 days | All aforementioned outcomes in patients with burns |
Countries
Netherlands
Outcome results
None listed