Drevet CM, Opprecht N, Nadji A, Mirek S, Aho S, Ricolfi F, Girard C, Bouhemad B. Impact of restrictive fluid protocol on hypoxemia after aneurysmal subarachnoid hemorrhage.
J Crit Care 2017;
42:152-156. [PMID:
28735155 DOI:
10.1016/j.jcrc.2017.07.031]
[Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Revised: 06/19/2017] [Accepted: 07/14/2017] [Indexed: 10/19/2022]
Abstract
PURPOSE
In patients with aneurysmal subarachnoid hemorrhage (aSAH), acute cardiac dysfunction and triple-H-therapy, can lead to hypoxemia. Our aim was to assess impact of a protocoled fluid restrictive approach on hypoxemia in these patients.
METHODS
We included prospectively ICU patients with aSAH admitted within 24h after the bleed. The study was divided into 2 phases. The first phase, from January to December 2012, was designated as control group (group C). The second phase, from February 2014 to January 2015, was designated as study group (group S). Between these periods, a protocoled fluid intake approach was implemented to maintain as low as possible the cumulative fluid balances.
RESULTS
Effective fluid restriction was obtained: at day 3 cumulative fluid balances were respectively for group C and group S, 1559±2402ml and 759±1855ml (p=0.04); and 2211±4918ml vs 529±2806ml (p=0.04) at day 7. We observed reduction in proportion of hypoxemic patient in group S compared to group C, at day 3 (22% vs 40%, p=0.047) and at day 7 (28% vs 57%, p=0.007).
CONCLUSIONS
Fluid restrictive management of patients with aSAH decreases number of hypoxemic patients at day 3 and day 7.
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