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

M. Diab, Sheren; M. Weheda, Sohair; Abbas, Nagwa; H. Nassar, Esraa; E Sayed, Safaa

doi:10.21608/ejhc.2021.190766

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

Authors

¹ Lecturer of Critical Care and Emergency Nursing, Faculty of Nursing, Tanta University, Egypt

² Professor of Medical Surgical Nursing, Faculty of Nursing, Alexandria University, Egypt

³ Lecturer of Emergency Medicine & Traumatology, Faculty of Medicine, Tanta University, Egypt

⁴ Assist prof of Critical Care and Emergency Nursing, Faculty of Nursing, Tanta University, Egypt.

10.21608/ejhc.2021.190766

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: social-
demographic 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.

Keywords