The Effect of Normovolemic versus Decreasing Maintenance Fluids on Critically Ill Multiple Trauma Patient’s Clinical Outcomes

Abstract

Background: Major trauma is a life-threatening emergency condition that requires immediate intervention. Resuscitation of low volume fluid or decreasing maintenance fluids maintains tissue perfusion and decreases the negative consequences of early vigorous resuscitation. Aim of the study was to evaluate the effect of normovolemic versus decreasing maintenance fluids on ICU multiple trauma patient's clinical outcomes. Method: A quasi experimental comparative research design was utilized in this study, purposive sample of 40 adult critically ill patients with multiple traumas would be enrolled sequentially into two groups, each group consists of ( 20) patients. This study was carried out in trauma intensive care unit at Emergency Hospital affiliated to Tanta University Hospitals, Egypt .Three tools were used to conduct the study. Tool I: socialdemographic and clinical data sheet, Tool II: injury severity score, Tool III: patients' outcome sheet. Results: There were sixty percent of patients in control group had age more than 30 years compared to 45% of patients in the study group. The male patient represents the highest percentage in this both groups. It was observed 90.0% of the study groups had injury severity score between (17-25) score. While 80.0% of the control groups has < 25 injury severity score level. a significant improvement regarding mean scores of pulse rate, respiratory rate, and Fio2 on discharge. The mean score of sodium, urea and creatinine was improved significantly among study groups compared with control groups on discharge where P= 0.022 and 0.00 respectively. Seventy percent of patients in control group had long duration of stay in ICU more than 20 days compared to (55.0%) of patients in the study group. Conclusion: It can be concluded that trauma patients in the ICU who received decreasing maintenance fluids at 30 mL/h in normotensive trauma patients had improved physiological parameters, decreased ICU stay and days on ventilator. Recommendations: Emergency hospital should include decreasing maintenance fluids for trauma patients admitted to the ICU if not contraindicated. Nursing and medical staff should be informed with the updated protocols of fluid resuscitation therapy and its application in clinical practice for emergency and critically ill patients.