Physiological Effects of 38°C vs. 22°C Fluid Therapy in Critically Ill Patients

This is an interventional treatment trial for Critical Illness focused on measuring Fluid therapy, Bolus Read More

Inclusion Criteria:

• Admission to the ICU
• Age 18 years or older
• Clinical decision to administer a fluid bolus of at least 500 ml of crystalloid over 15 minutes.
• Monitoring with either an arterial line in an extremity that can be used for pulse contour analysis (Vigileo, FloTrac or equivalent system) or a central venous catheter and a femoral arterial line that can be used for pulse contour analysis calibrated by thermodilution (EV1000, PiCCO or equivalent system)
• At least one of the following criteria for fluid administration must be met:
• MAP < 65 mmHg
• HR >100
• Urine output < 0,5ml/kg/h
• Lactate levels of > 3 mmol/l
• CI < 2.5L/min/m2
• SVV or PPV > 12% if mechanically ventilated with tidal volumes > 7 ml/kg
• ScvO2 or SvO2 < 65%

Exclusion Criteria:

• Active bleeding requiring transfusion
• Haemoglobin level <70 g/L
• Arrhythmia disturbing monitoring of cardiac output
• Patients in whom death is considered imminent (within 24 hours)
• CRRT
• Known pregnancy
• Active temperature control, either active warming or cooling
• Medical issue of pathological thermoregulation, such as malignant hyperthermia, thyroid storm, NMDA overdose, serotonin syndrome, malignant neuroleptic syndrome, or delirium.
• Planned exit from the ICU during the 2-hour monitoring period (planned surgical procedure, radiology, change of department etc.)