A randomized controlled clinical trial. 24 adult ICU patients will be recruited upon decision to administer fluid bolus of 500ml of crystalloid. The fluid will then be randomized to be infused at controlled room temperature or warmed to body temperature. Hemodynamic measurements will be made for 2 hours following the bolus, and laboratory values will be noted. The hypothesis is that part of the hemodynamic response will differed in response to cooling, and be larger in the cold group.
A randomized controlled clinical trial of the influence of fluid temperature on hemodynamic effects of fluids. 24 adult ICU patients meeting objective criteria of circulatory impairment (hypotension, tachycardia, lactatemia etc) will be recruited upon decision to administer fluid bolus of 500ml of crystalloid. The fluid will then be randomized to be infused at controlled room temperature of 22 degrees or warmed to body temperature at 38 degrees. All patients will be monitored with either calibrated or uncalibrated pulse contour analysis. Hemodynamic measurements (Heart rate (HR), Systolic blood pressure (SBP), Diastolic blood pressure (DBP), Mean arterial pressure (MAP), Cardiac output (CO), Cardiac index (CI), Stroke volume (SV), Stroke volume variation (SVV), Extravascular lung water (EVLW) etc) will be registered for 2 hours following the bolus, and laboratory values such as lactate, creatinine will be noted, as well as fluid balances. Confounders such as levels of vasopressors, sedation, switches in positioning och or ventilation will be registered. The hypothesis is that part of the hemodynamic response will differed in response to cooling, and be larger in the cold group.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Warming of administered fluid bolus
Administration of fluid bolus of crystalloid of 500ml over 15 minutes
Cooling of administered fluid bolus
Södersjukhuset
Stockholm, Sweden
Danderyds sjukhus
Stockholm, Sweden
MAP
Mean arterial pressure
Time frame: 15 minutes
MAP
Systolic blood pressure
Time frame: 1 hour
MAP
Systolic blood pressure
Time frame: 2 hours
SBP
Systolic blood pressure
Time frame: 15 minutes
SBP
Systolic blood pressure
Time frame: 1 hour
SBP
Systolic blood pressure
Time frame: 2 hours
DBP
Diastolic blood pressure
Time frame: 15 minutes
DBP
Diastolic blood pressure
Time frame: 1 hour
DBP
Diastolic blood pressure
Time frame: 2 hours
HR
Heart rate
Time frame: 15 minutes
HR
Heart rate
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Time frame: 1 hour
HR
Heart rate
Time frame: 2 hours
CO
Cardiac output
Time frame: 15 minutes
CO
Cardiac output
Time frame: 1 hour
CO
Cardiac output
Time frame: 2 hours
CI
Cardiac index
Time frame: 15 minutes
CI
Cardiac index
Time frame: 1 hour
CI
Cardiac index
Time frame: 2 hours
SV
Stroke volume
Time frame: 15 minutes
SV
Stroke volume
Time frame: 1 hour
SV
Stroke volume
Time frame: 2 hours
SVV
Stroke volume variation
Time frame: 15 minutes
SVV
Stroke volume variation
Time frame: 1 hour
SVV
Stroke volume variation
Time frame: 2 hours
EVLW
Extra vascular lung water
Time frame: 15 minutes
EVLW
Extra vascular lung water
Time frame: 1 hour
EVLW
Extra vascular lung water
Time frame: 2 hours
Type ofh eart rhythm
Heart rhythm
Time frame: 15 minutes
Type of heart rhythm
Heart rhythm
Time frame: 1 hour
Type of heart rhythm
Heart rhythm
Time frame: 2 hours
Levels of administered vasopressors
Amount of pressors
Time frame: 15 minutes
Levels of administered vasopressors
Amount of pressors
Time frame: 1 hours
Levels of administered vasopressors
Amount of pressors
Time frame: 2 hours
Levels of administered sedating medications
Amount of sedation
Time frame: 15 minutes
Levels of administered sedating medications
Amount of sedation
Time frame: 1 hours
Levels of administered sedating medications
Amount of sedation
Time frame: 2 hours
Lactate
Lactate
Time frame: 15 minutes
Levels of lactate
Lactate
Time frame: 1 hour
Levels of lactate
Lactate
Time frame: 2 hours
Hourly urine output
Urine output
Time frame: 1 hour
Hourly urine output
Urine output
Time frame: 2 hours
Temperature change
Temperature change
Time frame: 15 minutes
Temperature change
Temperature change
Time frame: 1 hour
Temperature change
Temperature change
Time frame: 2 hours
Daily fluid balance
Fluid balance
Time frame: 24 hours
Daily fluid balance
Fluid balance
Time frame: 48 hours