title: Defining the characteristics and expectations of fluid bolus therapy: A worldwide perspective.
abstract: The purpose of the study is to understand what clinicians believe defines fluid bolus therapy (FBT) and the expected response to such intervention.
  
  
  
  We asked intensive care specialists in 30 countries to participate in an electronic questionnaire of their practice, definition, and expectations of FBT.
  
  
  
  We obtained 3138 responses. Despite much variation, more than 80% of respondents felt that more than 250 mL of either colloid or crystalloid fluid given over less than 30 minutes defined FBT, with crystalloids most acceptable. The most acceptable crystalloid and colloid for use as FBT were 0.9% saline and 4% albumin solution, respectively. Most respondents believed that one or more of the following physiological changes indicates a response to FBT: a mean arterial pressure increase greater than 10 mm Hg, a heart rate decrease greater than 10 beats per minute, an increase in urinary output by more than 10 mL/h, an increase in central venous oxygen saturation greater than 4%, or a lactate decrease greater than 1 mmol/L.
  
  
  
  Despite wide variability between individuals and countries, clear majority views emerged to describe practice, define FBT, and identify a response to it. Further investigation is now required to describe actual FBT practice and to identify the magnitude and duration of the physiological response to FBT and its relationship to patient-centered outcomes.
authors.affiliation: Department of Intensive Care, Austin Hospital, Melbourne, VIC 3084, Australia; Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Prahran, VIC 3004, Australia. Electronic address: neil.glassford@austin.org.au.
authors.forename: Neil J
authors.initials: NJ
authors.lastname: Glassford
authors.affiliation: Department of Intensive Care, Austin Hospital, Melbourne, VIC 3084, Australia; Section of Anaesthesia and Intensive Care Medicine, Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Johan
authors.initials: J
authors.lastname: Mårtensson
authors.affiliation: Department of Intensive Care, Austin Hospital, Melbourne, VIC 3084, Australia; School of Nursing and Midwifery, Faculty of Health, Deakin University, Burwood, VIC 3125, Australia.
authors.forename: Glenn M
authors.initials: GM
authors.lastname: Eastwood
authors.affiliation: Department of Intensive Care, Austin Hospital, Melbourne, VIC 3084, Australia.
authors.forename: Sarah L
authors.initials: SL
authors.lastname: Jones
authors.affiliation: Department of Intensive Care, Austin Hospital, Melbourne, VIC 3084, Australia.
authors.forename: Aiko
authors.initials: A
authors.lastname: Tanaka
authors.affiliation: Department of Anesthesiology, Intensive Care Medicine and Pain Medicine, Helsinki University Hospital, Helsinki, Finland.
authors.forename: Erica
authors.initials: E
authors.lastname: Wilkman
authors.affiliation: Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Prahran, VIC 3004, Australia.
authors.forename: Michael
authors.initials: M
authors.lastname: Bailey
authors.affiliation: Department of Intensive Care, Austin Hospital, Melbourne, VIC 3084, Australia; Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Prahran, VIC 3004, Australia.
authors.forename: Rinaldo
authors.initials: R
authors.lastname: Bellomo
mesh_terms: D003422:Critical Care; D016638:Critical Illness / Q000628:therapy*; D000077324:Crystalloid Solutions; D005440:Fluid Therapy; D014943:Global Health; D006801:Humans; D007362:Intensive Care Units; D020407:Internet; D007552:Isotonic Solutions / Q000008:administration & dosage*; D010818:Practice Patterns, Physicians'; D011795:Surveys and Questionnaires
chemical_list: D000077324:Crystalloid Solutions; D007552:Isotonic Solutions
keywords: Critical care; Fluid bolus therapy; Fluid resuscitation; Hemodynamic optimization