The goal of this international inception cohort study is to describe fluid administration during admittance to the intensive care unit (ICU), and provide contemporary epidemiological data on fluid accumulation, risk factors, management and outcome in critically ill adult patients.
Background: Fluid accumulation is associated with adverse outcome in ICU patients, however, assessment of fluid status is often difficult and no established definition and consistent detection method exists. Former research has primarily focused on the use of resuscitation fluid, but a substantial amount of fluid is administered throughout the entire ICU stay and this fluid may be a clinically relevant source of fluid accumulation. Objectives: To describe fluid administration practices during the entire ICU stay, and provide contemporary epidemiological data on fluid accumulation, fluid removal, risk factors and association with patient outcomes from a worldwide perspective. Study design: International inception cohort study. Patients will be included during a 14-day inception period to be chosen by each participating site. Population: Critically ill adult patients (≥ 18 years) with acute admission to the ICU. Intervention: None. Only routinely available data will be collected. Study duration: Patients are followed daily until ICU discharge or death for a maximum of 28 days. Follow-up is performed 90 days after ICU admission.
Study Type
OBSERVATIONAL
Enrollment
1,000
The number of patients with fluid accumulation.
The presence of fluid accumulation is defined as the best clinical estimate made by the study investigators, using medical records and the treating team's clinical assessment, and one or more of the following parameters: Cumulative fluid balance, daily fluid balance, changes in body weight, and/or clinical signs of fluid accumulation (e.g. peripheral oedema, pulmonary oedema, congestion on chest X-ray or lung ultrasound).
Time frame: From ICU admission to discharge (with a maximum of 28 days).
Number of patients with fluid accumulation upon ICU admission (baseline).
Defined as the number of patients with fluid accumulation upon ICU admission or equal to the time of ICU assessed by study investigators using cumulative fluid balance, daily fluid balance, changes in body weight and clinical signs of fluid accumulation.
Time frame: On the first day of ICU admission (Day 1).
Number of patients developing fluid accumulation during the ICU stay.
Defined as the number of patients developing fluid accumulation during ICU stay (one or more episodes) but no pre-existing fluid accumulation upon ICU admission (baseline form).
Time frame: 28 days
Number of days with fluid accumulation during the ICU stay.
Defined as the median number of days with fluid accumulation in patient with fluid accumulation at baseline and/or during ICU stay at day 28 after ICU admission.
Time frame: 28 days
Number of patients being treated with 'active fluid removal' (use of diuretics, or renal replacement therapy).
Defined as patients that receive treatment with any type of diuretics or renal replacement therapy.
Time frame: 28 days
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Deparment of Intensive care, Nordsjællands hospital
Hillerød, Hillerød, Denmark
Department of Intensive Care, Sygehus Sønderjylland Aabenraa
Aabenraa, Denmark
NOT_YET_RECRUITINGDepartmen of Intensive Care
Aalborg, Denmark
ACTIVE_NOT_RECRUITINGDepartment of Intensive Care, University hospital Aarhus
Aarhus, Denmark
NOT_YET_RECRUITINGDepartment of Intensive Care, Rigshospitalet 4131
Copenhagen, Denmark
RECRUITINGDepartment of Intensive Care, Bispebjerg
Copenhagen, Denmark
RECRUITINGDepartment of Intensive Care, Herlev Hospital
Herlev, Denmark
COMPLETEDDepartment of Intensive Care, Regionshospital Gødstrup
Herning, Denmark
ACTIVE_NOT_RECRUITINGDepartment of Intensive Care, Zealand University hospital
Køge, Denmark
COMPLETEDDepartment of Intensive Care, Regionshospitalet Randers
Randers, Denmark
ACTIVE_NOT_RECRUITING...and 11 more locations
Days alive without use of life-support within 28 days from ICU admission.
Days alive without use of life-support (continuous infusion of vasopressors/inotropes, invasive mechanical ventilation or renal replacement therapy).
Time frame: 28 days
Days alive and out of hospital within 90 days from ICU admission.
Total number of days alive and out of hospital within 90 days from ICU admission,
Time frame: 90 days
Mortality within 90 days from ICU admission.
Death from all causes.
Time frame: 90 days