IV Fluid Bolus Fails To Prevent Cardiovascular Collapse In I
A randomized clinical trial enrolling 1067 critically ill adults undergoing tracheal intubation with sedation and positive pressure ventilation at 11 intensive care units in the US between February 1, 2019, and May 24, 2021. The date of final follow-up was June 21, 2021. Patients were randomly assigned to receive either a 500-mL intravenous fluid bolus (n=538) or no fluid bolus (n=527).

Among 1067 patients randomized, 1065 (99.8%) completed the trial and were included in the primary analysis (median age, 62 years [IQR, 51-70 years]; 42.1% were women). Cardiovascular collapse occurred in 113 patients (21.0%) in the fluid bolus group and in 96 patients (18.2%) in the no fluid bolus group (absolute difference, 2.8% [95% CI, 2.2% to 7.7%]; P=.25). New or increased receipt of vasopressors occurred in 20.6% of patients in the fluid bolus group compared with 17.6% of patients in the no fluid bolus group, a systolic blood pressure of less than 65 mm Hg occurred in 3.9% vs 4.2%, respectively, cardiac arrest occurred in 1.7% vs 1.5%, and death occurred in 0.7% vs 0.6%. Death prior to day 28 (censored at hospital discharge) occurred in 218 patients (40.5%) in the fluid bolus group compared with 223 patients (42.3%) in the no fluid bolus group (absolute difference, 1.8% [95% CI, 7.9% to 4.3%]; P=.55).

Among critically ill adults undergoing tracheal intubation, administration of an intravenous fluid bolus compared with no fluid bolus did not significantly decrease the incidence of cardiovascular collapse.

Source: https://jamanetwork.com/journals/jama/fullarticle/2793545?guestAccessKey=ff776875-ff5d-4df7-b62b-eb489a347c32&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm;_c
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