Hemodynamics, fluids & transfusion
Determinants of fluid use and the association between volume of fluid used and effect of balanced solutions on mortality in critically ill patients: a secondary analysis of the Balanced Solution in Intensive Care Study (BaSICS) trial
An erratum to this article was published (Intensive Care Med, Jan 2024 ↗)
Authors' conclusion
Baseline patient characteristics collected in the BaSICS trial explain less of the variance of fluid use during the first 3 days than the enrolling site. Volume of fluid used and the effects of BS appear to interact, mostly in the sepsis subgroup where there was a strong association between fluid use after enrollment and the effect of BS on 90-day mortality.
Study context
- Population
- Critically ill intensive care unit (ICU) patients in the BaSICS trialanalysed
- Participants
- 10,505 patients
- Comparison
- Plasma-Lyte 148® vs 0.9% saline for ICU fluid therapy
- Primary endpoint
- Relative contribution of patient features vs enrolling site to volume of fluid used; modulation of BS effect on 90-day mortality by fluid volume
- Follow-up
- Up to day 3 after admission
Methodological detailsBayesian regression, frequentist mixed model, random forest, Bayesian network accounting for competing risks, subgroup analysis
- Bayesian regression
- Frequentist mixed model
- Random forest
- Bayesian network accounting for competing risks
- Subgroup analysis
Primary result
As reported in the abstract
Volume of fluid used up to day 3 and variance explained by enrolling site · up to day 3
- Variance explained by random effect (enrolling site), Bayesian regression; 95% CrI 0.24-0.41; of total model variance 0.33
- 0.32 (95% CrI 0.32-0.35)
Further findings
| Outcome | Absolute risk reduction (95% CrI) |
|---|---|
| 90-day mortality, septic patients at high fluid use sites (site practice analysis; subgroup) · 0.98 probability of benefit; CrI | - 0.13 (- 0.27 to - 0.01) |
Interaction of fluid use and balanced solutions (BS) effect on 90-day mortality (patients alive and in ICU at 3 days)
- Strong suggestion of interaction, driven mostly by lower mortality with BS vs 0.9% saline as fluid use increased in sepsis; consistent in Bayesian network analysis
Original publication
Determinants of fluid use and the association between volume of fluid used and effect of balanced solutions on mortality in critically ill patients: a secondary analysis of the BaSICS trial. Intensive Care Med. Published 27 November 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →