title: Resuscitation fluid use in Australian and New Zealand Intensive Care Units between 2007 and 2013.
abstract: BACKGROUND
  Recent evidence indicates that the choice of intravenous fluids may affect outcomes in critically ill patients.
  
  
  METHODS
  We recorded the administration of resuscitation fluids in patients admitted to Australian and New Zealand adult intensive care units (ICUs) for a 24-h period at 6 time points between 2007 and 2013. Changes in patterns of fluid use over this period were determined using regression analyses.
  
  
  RESULTS
  Of the 2825 patients admitted to the 61 ICUs on the 6 study days, 754 (26.7%) patients received fluid resuscitation. Of those receiving fluid resuscitation, the proportion of patients receiving crystalloid significantly increased from 28.9% (41/142) in 2007 to 50.5% (48/95) in 2013 (adjusted odds ratio (OR) 2.93; 95% confidence intervals (CI) 1.35-6.33; p = 0.006); of these, the proportion of patients receiving buffered salt solutions significantly increased from 4.9% (7/142) in 2007 to 31.6% (30/95) in 2013 (OR 7.00; 95% CI 2.14-22.92; p = 0.001). The use of colloids significantly decreased from 59.9% (85/142) in 2007 to 42.1% (40/95) in 2013 (adjusted OR 0.34; 95% CI 0.16-0.74; p = 0.007) due to a significant decrease in the proportion of patients receiving gelatin; 28.9% (41/142) to 2.1% (2/95) (OR 0.10; 95% CI 0.03-0.29; p ≤ 0.001).
  
  
  CONCLUSIONS
  Fluid resuscitation practice in Australia and New Zealand adult ICUs has changed over the 6-year study period. Crystalloid use increased primarily due to an increase in the use of buffered salt solutions while overall the use of colloid has decreased.
authors.affiliation: Division of Critical Care and Trauma, The George Institute for Global Health, University of Sydney, Sydney, Australia, nhammond@georgeinstitute.org.au.
authors.forename: N E
authors.initials: NE
authors.lastname: Hammond
authors.forename: C
authors.initials: C
authors.lastname: Taylor
authors.forename: M
authors.initials: M
authors.lastname: Saxena
authors.forename: B
authors.initials: B
authors.lastname: Liu
authors.forename: S
authors.initials: S
authors.lastname: Finfer
authors.forename: P
authors.initials: P
authors.lastname: Glass
authors.forename: I
authors.initials: I
authors.lastname: Seppelt
authors.forename: L
authors.initials: L
authors.lastname: Willenberg
authors.forename: J
authors.initials: J
authors.lastname: Myburgh
mesh_terms: D001315:Australia; D003102:Colloids / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D000077324:Crystalloid Solutions; D005260:Female; D005440:Fluid Therapy; D006801:Humans; D007362:Intensive Care Units; D007552:Isotonic Solutions / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009520:New Zealand; D015532:Rehydration Solutions / Q000627:therapeutic use; D012151:Resuscitation / Q000379:methods*; D013997:Time Factors
chemical_list: D003102:Colloids; D000077324:Crystalloid Solutions; D007552:Isotonic Solutions; D015532:Rehydration Solutions