title: Maintenance fluid practices in intensive care units in Australia and New Zealand.
abstract: BACKGROUND
  Administration of maintenance fluid is common practice in the intensive care unit, contributing to daily fluid and sodium intake and balance. Despite this, there is little evidence to describe clinical practices relating to its administration to ICU patients.
  
  
  METHODS
  We conducted a prospective, observational, point-prevalence study in 49 Australian and New Zealand ICUs in 2014. We aimed to document the type and volume of maintenance fluid administered to ICU patients, and to describe additional fluid received. We also assessed changes in maintenance fluid administration practices compared with our similar study conducted in 2011.
  
  
  RESULTS
  Of 645 patients enrolled, 399 (62%) received maintenance fluid on the study day. A median volume of 630 mL (interquartile range [IQR], 272-1250 mL) was delivered, accounting for a median of 35% (IQR, 16%- 56%) of total daily administered fluids. This was in addition to other fluids administered as fluid resuscitation, drug infusions and boluses, flushes and enteral or parenteral feeds, as well as oral intake. 0.9% saline was the most commonly used maintenance fluid (36%), followed by balanced salt solutions (30%). Compared with data from 2011, there has been a decrease in the median volume of maintenance fluid administered (2011, 860 mL [IQR, 360- 1533 mL]; 2014, 630 mL [IQR, 287-1328 mL]; P = 0.01), although the proportion of patients receiving maintenance fluid remains unchanged. There has been no change in the types of fluids most commonly used for maintenance, but the use of balanced salt solutions has increased (2011, 24%; 2014, 30%; P = 0.01).
  
  
  CONCLUSIONS
  Administration of maintenance fluids to patients in Australian and New Zealand ICUs is common. Although the volume being delivered has decreased, maintenance fluids contribute over one-third of daily total fluid administration.
authors.affiliation: Department of Intensive and Critical Care, Flinders Medical Centre, Adelaide, SA, Australia. biharishailesh@gmail.com.
authors.forename: Shailesh
authors.initials: S
authors.lastname: Bihari
authors.affiliation: Division of Critical Care and Trauma, The George Institute for Global Health, Sydney, NSW, Australia.
authors.forename: Nicola R
authors.initials: NR
authors.lastname: Watts
authors.affiliation: Division of Critical Care and Trauma, The George Institute for Global Health, Sydney, NSW, Australia.
authors.forename: Ian
authors.initials: I
authors.lastname: Seppelt
authors.affiliation: Division of Critical Care and Trauma, The George Institute for Global Health, Sydney, NSW, Australia.
authors.forename: Kelly
authors.initials: K
authors.lastname: Thompson
authors.affiliation: Division of Critical Care and Trauma, The George Institute for Global Health, Sydney, NSW, Australia.
authors.forename: Ashleigh
authors.initials: A
authors.lastname: Myburgh
authors.affiliation: Department of Intensive and Critical Care, Flinders Medical Centre, Adelaide, SA, Australia.
authors.forename: Shivesh
authors.initials: S
authors.lastname: Prakash
authors.affiliation: Department of Intensive and Critical Care, Flinders Medical Centre, Adelaide, SA, Australia.
authors.forename: Andrew
authors.initials: A
authors.lastname: Bersten
mesh_terms: D001315:Australia; D003422:Critical Care / Q000379:methods* / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005260:Female; D005440:Fluid Therapy / Q000379:methods* / Q000706:statistics & numerical data*; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D009520:New Zealand; D011446:Prospective Studies