ArticleClinicoEconomics and outcomes research : CEOR2015
The costs of fluid overload in the adult intensive care unit: is a small-volume infusion model a proactive solution?
Article in ClinicoEconomics and outcomes research : CEOR, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02523872 (Description of Fluid Balance in Patients With Acute Respiratory Failure), which is not on this map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Description of Fluid Balance in Patients With Acute Respiratory Failure
Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Comparative Efficacy and Safety of Clevidipine Versus Nicardipine in Hypertensive Emergencies: A Systematic Review and Meta-Analysis.Clinical cardiology · 2026Pooled it
- Diuretic therapy for critically ill patients: a systematic review and network meta-analysis.Annals of intensive care · 2026Article
- Machine learning-enabled prediction of prolonged length of stay in hospital after surgery for tuberculosis spondylitis patients with unbalanced data: a novel approach using explainable artificial intelligence (XAI).European journal of medical research · 2024Article
- Impact of a Pharmacist-Driven Medication Diluent Volume Optimization Protocol on Fluid Balance and Outcomes in Critically Ill Patients.Hospital pharmacy · 2024Article
- Objective Methods of Assessing Fluid Status to Optimize Volume Management in Kidney Disease and Hypertension: The Importance of Ultrasound.Journal of clinical medicine · 2023Review
- Article
- Economic Analysis of Renal Replacement Therapy Modality in Acute Kidney Injury Patients With Fluid Overload.Critical care explorations · 2023Article
- Lung Ultrasound-Guided Fluid Management versus Standard Care in Surgical ICU Patients: A Randomised Controlled Trial.Diagnostics (Basel, Switzerland) · 2021Article
- Fluid Stewardship During Critical Illness: A Call to Action.Journal of pharmacy practice · 2020Article
- Albumin Use After Cardiac Surgery.Critical care explorations · 2020Article
- Article
- Comparison of real-world clinical and economic outcomes between the ThermoCoolClinicoEconomics and outcomes research : CEOR · 2018Article
- How to avoid fluid overload.Current opinion in critical care · 2015Review
- Retrospective Evaluation of Risk Factors and Outcome in Dogs With and Without Fluid Overload During Hospitalization.Journal of veterinary internal medicineArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeFluid overload (FO) in critically ill patients remains a challenging clinical dilemma, and many continuous intravenous (IV) medications in the US are being delivered as a dilute solution, adding significantly to a patient's daily intake. This study describes the costs and outcomes of FO in patients receiving multiple continuous infusions. MATERIALS AND
methodsA retrospective study was conducted using a hospital administrative database covering >500 US hospitals. An FO cohort included adult intensive care unit (ICU) patients with a central line receiving IV loop diuretics and 2+ continuous IV infusions on 50%+ of their ICU days; a directly matched non-FO cohort included patients without IV diuretic use. The primary outcome of the study was total hospitalization costs per visit. Additional outcomes were ICU costs, mortality, total and ICU length of stay (LOS), 30-day readmission rates, and ventilator use. Unadjusted descriptive analysis was performed using chi-squared or paired t-tests to compare outcomes between the two cohorts.
resultsA total of 63,974 patients were identified in each cohort. The total hospitalization cost per visit for the FO cohort was US$15,344 higher than the non-FO cohort (US$42,386 vs US$27,042), and the ICU cost for the FO cohort was US$5,243 higher than the non-FO cohort (US$10,902 vs US$5,659). FO patients had higher mortality (20% vs 16.8%), prolonged LOS (11.5 vs 8.0 days), longer ICU LOS (6.2 vs 3.6 days), higher risk of 30-day readmission (21.8% vs 21.3%), and ventilator usage (47.7% vs 28.3%) than the non-FO cohort (all P<0.05).
conclusionIn patients receiving multiple continuous infusions, FO is associated with increased health care resources and costs. Maximally concentrating medications and proactively providing continuous medications in small-volume infusions (SVI) could be a potential solution to prevent iatrogenic FO in critically ill patients. Further prospective research is warranted to assess the impact of the SVI dispensing model on patient outcomes and health care costs.
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