Jens Aage Kølsen Petersen

Twenty-four-hour fluid administration in emergency department patients with suspected infection: A multicenter, prospective, observational study

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Twenty-four-hour fluid administration in emergency department patients with suspected infection : A multicenter, prospective, observational study. / Jessen, Marie K.; Andersen, Lars W.; Thomsen, Marie Louise H.; Jensen, Marie E.; Kirk, Mathilde E.; Kildegaard, Sofie; Petersen, Poul; Mohey, Rajesh; Madsen, Anders H.; Perner, Anders; Petersen, Jens Aage Kølsen; Kirkegaard, Hans.

I: Acta Anaesthesiologica Scandinavica, Bind 65, Nr. 8, 09.2021, s. 1122-1142.

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avisTidsskriftartikelForskningpeer review

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@article{257e06a300b0467984549bc62d06c9e9,
title = "Twenty-four-hour fluid administration in emergency department patients with suspected infection: A multicenter, prospective, observational study",
abstract = "Background: To describe 24-hour fluid administration in emergency department (ED) patients with suspected infection. Methods: A prospective, multicenter, observational study conducted in three Danish hospitals, January 20 to March 2, 2020. We included consecutive adult ED patients with suspected infection (drawing of blood culture and/or intravenous antibiotic administration within 6 hours of admission). Oral and intravenous fluids were registered for 24 hours. Primary outcome: 24-hour total fluid volume. We used linear regression to investigate patient and disease characteristics' effect on 24-hour fluids and to estimate the proportion of the variance in fluid administration explained by potential predictors. Results: 734 patients had 24-hour fluids available: 387 patients had simple infection, 339 sepsis, eight septic shock. Mean total 24-hour fluid volumes were 3656 mL (standard deviation [SD]:1675), 3762 mL (SD: 1839), and 6080 mL (SD: 3978) for the groups, respectively. Fluid volumes varied markedly. Increasing age (mean difference [MD]: 60-79 years: −470 mL [95% CI: −789, −150], +80 years; −974 mL [95% CI: −1307, −640]), do-not-resuscitate orders (MD: −466 mL [95% CI: −797, −135]), and preexisting atrial fibrillation (MD: −367 mL [95% CI: −661, −72) were associated with less fluid. Systolic blood pressure < 100 mmHg (MD: 1182 mL [95% CI: 820, 1543]), mean arterial pressure < 65 mmHg (MD: 1317 mL [95% CI: 770, 1864]), lactate ≥ 2 mmol/L (MD: 655 mL [95% CI: 306, 1005]), heart rate > 120 min (MD: 566 [95% CI: 169, 962]), low (MD: 1963 mL [95% CI: 813, 3112]) and high temperature (MD: 489 mL [95% CI: 234, 742]), SOFA score > 5 (MD: 1005 mL [95% CI: 501, 510]), and new-onset atrial fibrillation (MD: 498 mL [95% CI: 30, 965]) were associated with more fluid. Clinical variables explained 37% of fluid variation among patients. Conclusions: Patients with simple infection and sepsis received equal fluid volumes. Fluid volumes varied markedly, a variation that was partly explained by clinical characteristics.",
keywords = "emergency department, fluid therapy, infection, sepsis",
author = "Jessen, {Marie K.} and Andersen, {Lars W.} and Thomsen, {Marie Louise H.} and Jensen, {Marie E.} and Kirk, {Mathilde E.} and Sofie Kildegaard and Poul Petersen and Rajesh Mohey and Madsen, {Anders H.} and Anders Perner and Petersen, {Jens Aage K{\o}lsen} and Hans Kirkegaard",
note = "Publisher Copyright: {\textcopyright} 2021 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd",
year = "2021",
month = sep,
doi = "10.1111/aas.13848",
language = "English",
volume = "65",
pages = "1122--1142",
journal = "Acta Anaesthesiologica Scandinavica",
issn = "0001-5172",
publisher = "Wiley-Blackwell Publishing, Inc.",
number = "8",

}

RIS

TY - JOUR

T1 - Twenty-four-hour fluid administration in emergency department patients with suspected infection

T2 - A multicenter, prospective, observational study

AU - Jessen, Marie K.

AU - Andersen, Lars W.

AU - Thomsen, Marie Louise H.

AU - Jensen, Marie E.

AU - Kirk, Mathilde E.

AU - Kildegaard, Sofie

AU - Petersen, Poul

AU - Mohey, Rajesh

AU - Madsen, Anders H.

AU - Perner, Anders

AU - Petersen, Jens Aage Kølsen

AU - Kirkegaard, Hans

N1 - Publisher Copyright: © 2021 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd

PY - 2021/9

Y1 - 2021/9

N2 - Background: To describe 24-hour fluid administration in emergency department (ED) patients with suspected infection. Methods: A prospective, multicenter, observational study conducted in three Danish hospitals, January 20 to March 2, 2020. We included consecutive adult ED patients with suspected infection (drawing of blood culture and/or intravenous antibiotic administration within 6 hours of admission). Oral and intravenous fluids were registered for 24 hours. Primary outcome: 24-hour total fluid volume. We used linear regression to investigate patient and disease characteristics' effect on 24-hour fluids and to estimate the proportion of the variance in fluid administration explained by potential predictors. Results: 734 patients had 24-hour fluids available: 387 patients had simple infection, 339 sepsis, eight septic shock. Mean total 24-hour fluid volumes were 3656 mL (standard deviation [SD]:1675), 3762 mL (SD: 1839), and 6080 mL (SD: 3978) for the groups, respectively. Fluid volumes varied markedly. Increasing age (mean difference [MD]: 60-79 years: −470 mL [95% CI: −789, −150], +80 years; −974 mL [95% CI: −1307, −640]), do-not-resuscitate orders (MD: −466 mL [95% CI: −797, −135]), and preexisting atrial fibrillation (MD: −367 mL [95% CI: −661, −72) were associated with less fluid. Systolic blood pressure < 100 mmHg (MD: 1182 mL [95% CI: 820, 1543]), mean arterial pressure < 65 mmHg (MD: 1317 mL [95% CI: 770, 1864]), lactate ≥ 2 mmol/L (MD: 655 mL [95% CI: 306, 1005]), heart rate > 120 min (MD: 566 [95% CI: 169, 962]), low (MD: 1963 mL [95% CI: 813, 3112]) and high temperature (MD: 489 mL [95% CI: 234, 742]), SOFA score > 5 (MD: 1005 mL [95% CI: 501, 510]), and new-onset atrial fibrillation (MD: 498 mL [95% CI: 30, 965]) were associated with more fluid. Clinical variables explained 37% of fluid variation among patients. Conclusions: Patients with simple infection and sepsis received equal fluid volumes. Fluid volumes varied markedly, a variation that was partly explained by clinical characteristics.

AB - Background: To describe 24-hour fluid administration in emergency department (ED) patients with suspected infection. Methods: A prospective, multicenter, observational study conducted in three Danish hospitals, January 20 to March 2, 2020. We included consecutive adult ED patients with suspected infection (drawing of blood culture and/or intravenous antibiotic administration within 6 hours of admission). Oral and intravenous fluids were registered for 24 hours. Primary outcome: 24-hour total fluid volume. We used linear regression to investigate patient and disease characteristics' effect on 24-hour fluids and to estimate the proportion of the variance in fluid administration explained by potential predictors. Results: 734 patients had 24-hour fluids available: 387 patients had simple infection, 339 sepsis, eight septic shock. Mean total 24-hour fluid volumes were 3656 mL (standard deviation [SD]:1675), 3762 mL (SD: 1839), and 6080 mL (SD: 3978) for the groups, respectively. Fluid volumes varied markedly. Increasing age (mean difference [MD]: 60-79 years: −470 mL [95% CI: −789, −150], +80 years; −974 mL [95% CI: −1307, −640]), do-not-resuscitate orders (MD: −466 mL [95% CI: −797, −135]), and preexisting atrial fibrillation (MD: −367 mL [95% CI: −661, −72) were associated with less fluid. Systolic blood pressure < 100 mmHg (MD: 1182 mL [95% CI: 820, 1543]), mean arterial pressure < 65 mmHg (MD: 1317 mL [95% CI: 770, 1864]), lactate ≥ 2 mmol/L (MD: 655 mL [95% CI: 306, 1005]), heart rate > 120 min (MD: 566 [95% CI: 169, 962]), low (MD: 1963 mL [95% CI: 813, 3112]) and high temperature (MD: 489 mL [95% CI: 234, 742]), SOFA score > 5 (MD: 1005 mL [95% CI: 501, 510]), and new-onset atrial fibrillation (MD: 498 mL [95% CI: 30, 965]) were associated with more fluid. Clinical variables explained 37% of fluid variation among patients. Conclusions: Patients with simple infection and sepsis received equal fluid volumes. Fluid volumes varied markedly, a variation that was partly explained by clinical characteristics.

KW - emergency department

KW - fluid therapy

KW - infection

KW - sepsis

UR - http://www.scopus.com/inward/record.url?scp=85105801262&partnerID=8YFLogxK

U2 - 10.1111/aas.13848

DO - 10.1111/aas.13848

M3 - Journal article

C2 - 33964019

AN - SCOPUS:85105801262

VL - 65

SP - 1122

EP - 1142

JO - Acta Anaesthesiologica Scandinavica

JF - Acta Anaesthesiologica Scandinavica

SN - 0001-5172

IS - 8

ER -