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- W4313222612 abstract "Introduction: Fluid stewardship principles have been proposed to improve volume status and prevent adverse outcomes related to fluid overload. In the multi-disciplinary setting, intravenous fluid (IVF) management may be further enhanced through pharmacist-driven interventions. The aim of this pre-post study is to evaluate the impact of multi-disciplinary rounds (MDR) on initial 72-hour IVF administration. Methods: This was a single-center, retrospective study conducted before and after MDR implementation in the medical and surgical intensive care units (ICU). Adult patients were included if they received maintenance IVF within 24 hours of ICU admission from October 2017 to March 2018 for the pre-MDR group and October 2020 to March 2021 for the post-MDR group. The primary endpoint was the change in total IVF intake within 72 hours of ICU admission. IVF administration was individually analyzed by source. Fluid sources other than maintenance IVF were categorized as hidden fluids. Secondary endpoints included 72-hour cumulative fluid balance (CFB), mechanical ventilation (MV) days, incidence of acute kidney injury (AKI), hospital and ICU length of stay (LOS), all-cause mortality, and documented pharmacist interventions related to fluid management. Results: A total of 211 patients were included, 115 in the pre-MDR group and 96 in the post-MDR group. The median total IVF intake at 72 hours was significantly reduced in the post-MDR group (8196 mL [4763-12135] vs 9398 mL [6469-14147]; p=0.007). Hidden fluid administration was similar between groups (2617 mL [1318-5455] vs 2876 mL [945-6367]; p=0.94); however, maintenance IVF was associated with reduced intake following MDR implementation (4185 mL [2412-6341] vs 6223 mL [2412-6341]; p< 0.0001). Significantly more patients in the post-MDR group had fluid-related pharmacist interventions compared to pre-MDR (71 [75%] vs 29 [25%]; p< 0.0001). There were no significant differences in the other secondary outcomes. Conclusions: The implementation of MDR was associated with a significant reduction in total IVF administration within the initial 72 hours of ICU admission. Further prospective research is needed to evaluate the relationship between fluid-related interventions and patient outcomes." @default.
- W4313222612 created "2023-01-06" @default.
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- W4313222612 date "2022-12-15" @default.
- W4313222612 modified "2023-10-18" @default.
- W4313222612 title "1147: IMPACT OF MULTIDISCIPLINARY ROUNDS ON INTRAVENOUS FLUID ADMINISTRATION IN THE INTENSIVE CARE UNIT" @default.
- W4313222612 doi "https://doi.org/10.1097/01.ccm.0000910324.31416.91" @default.
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