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Maintenance fluid therapy and fluid creep impose more significant fluid, sodium, and chloride burdens than resuscitation fluids in critically ill patients: a retrospective study in a tertiary mixed…

Overview of attention for article published in Intensive Care Medicine, March 2018
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About this Attention Score

  • In the top 5% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (95th percentile)
  • High Attention Score compared to outputs of the same age and source (89th percentile)

Mentioned by

twitter
105 tweeters
facebook
2 Facebook pages

Citations

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20 Dimensions

Readers on

mendeley
81 Mendeley
Title
Maintenance fluid therapy and fluid creep impose more significant fluid, sodium, and chloride burdens than resuscitation fluids in critically ill patients: a retrospective study in a tertiary mixed ICU population
Published in
Intensive Care Medicine, March 2018
DOI 10.1007/s00134-018-5147-3
Pubmed ID
Authors

Niels Van Regenmortel, Walter Verbrugghe, Ella Roelant, Tim Van den Wyngaert, Philippe G. Jorens

Abstract

Research on intravenous fluid therapy and its side effects, volume, sodium, and chloride overload, has focused almost exclusively on the resuscitation setting. We aimed to quantify all fluid sources in the ICU and assess fluid creep, the hidden and unintentional volume administered as a vehicle for medication or electrolytes. We precisely recorded the volume, sodium, and chloride burdens imposed by every fluid source administered to 14,654 patients during the cumulative 103,098 days they resided in our 45-bed tertiary ICU and simulated the impact of important strategic fluid choices on patients' chloride burdens. In septic patients, we assessed the impact of the different fluid sources on cumulative fluid balance, an established marker of morbidity. Maintenance and replacement fluids accounted for 24.7% of the mean daily total fluid volume, thereby far exceeding resuscitation fluids (6.5%) and were the most important sources of sodium and chloride. Fluid creep represented a striking 32.6% of the mean daily total fluid volume [median 645 mL (IQR 308-1039 mL)]. Chloride levels can be more effectively reduced by adopting a hypotonic maintenance strategy [a daily difference in chloride burden of 30.8 mmol (95% CI 30.5-31.1)] than a balanced resuscitation strategy [daily difference 3.0 mmol (95% CI 2.9-3.1)]. In septic patients, non-resuscitation fluids had a larger absolute impact on cumulative fluid balance than did resuscitation fluids. Inadvertent daily volume, sodium, and chloride loading should be avoided when prescribing maintenance fluids in view of the vast amounts of fluid creep. This is especially important when adopting an isotonic maintenance strategy.

Twitter Demographics

The data shown below were collected from the profiles of 105 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 81 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 81 100%

Demographic breakdown

Readers by professional status Count As %
Other 21 26%
Researcher 15 19%
Student > Postgraduate 7 9%
Student > Ph. D. Student 7 9%
Professor 5 6%
Other 15 19%
Unknown 11 14%
Readers by discipline Count As %
Medicine and Dentistry 55 68%
Nursing and Health Professions 3 4%
Biochemistry, Genetics and Molecular Biology 2 2%
Pharmacology, Toxicology and Pharmaceutical Science 1 1%
Environmental Science 1 1%
Other 1 1%
Unknown 18 22%

Attention Score in Context

This research output has an Altmetric Attention Score of 65. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 26 October 2019.
All research outputs
#290,164
of 14,188,147 outputs
Outputs from Intensive Care Medicine
#162
of 3,648 outputs
Outputs of similar age
#11,879
of 276,370 outputs
Outputs of similar age from Intensive Care Medicine
#10
of 98 outputs
Altmetric has tracked 14,188,147 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 97th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 3,648 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 12.5. This one has done particularly well, scoring higher than 95% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 276,370 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 95% of its contemporaries.
We're also able to compare this research output to 98 others from the same source and published within six weeks on either side of this one. This one has done well, scoring higher than 89% of its contemporaries.