Original Research
Saturday, October 12, 2024
11:30 AM–01:00 PM
Abstract
Introduction: The 2021 Surviving Sepsis Campaign guidelines recommend initial fluid resuscitation of 30 ml/kg using ideal body weight (IBW). The impact of weight-based fluid dosing using IBW compared to actual body weight on patient outcomes is unknown.
Research Question or Hypothesis: Does resuscitation fluid dosing based on IBW affect the need for mechanical ventilation (MV) in septic shock?
Study Design: Single-center, retrospective, observational cohort study
Methods: A convenience sample of 200 adult patients admitted to the intensive care unit between 11/01/2020 and 01/31/2023 with a diagnosis of septic shock were identified. Patients were divided into tertiles based on the volume per kilogram of IBW of resuscitation fluids received within three hours of presentation. Primary and secondary endpoints included the need for and duration of MV and were compared between groups with the Chi-squared and Kruskal-Wallis test, respectively. Binary logistic regression and multiple linear regression were applied to control for confounding variables.
Results: Patients were a median age of 67 years, predominantly Caucasian, had a median BMI of 26.9, and 33% had preexisting heart failure. Each tertile received a median volume of resuscitation fluid of 24.3, 33.4, and 49.5 mL/kg IBW (p<0.001). Initiation and duration of MV were similar regardless of receiving more or less than guideline-recommended volume of resuscitation fluid (MV: 43% vs 46% vs 37%, p=0.308; duration: 51 vs 41 vs 97 hours, p=0.174). When controlling for confounding variables, weight-based dosing of resuscitation fluid was not associated with need for MV and there was trend towards an association with duration of MV (beta coefficient -1.065, p = 0.077).
Conclusion: The need for and duration of MV was not affected by the volume of resuscitation fluids administered by IBW in the first 3 hours of septic shock. Dosing weight used for resuscitation fluids should be further evaluated to determine any impact on patient outcomes.
Presenting Author
Alyssa Sangalang PharmD Candidate 2025University of Georgia, College of Pharmacy
Authors
Trisha N. Branan PharmD, BCCCP, FCCM
University of Georgia College of Pharmacy
W. Anthony Hawkins PharmD, FCCM, BCCCP
Medical College of Georgia at Augusta University
Susan E. Smith PharmD, BCCCP, FCCM
University of Georgia College of Pharmacy
S. Madison Walters PharmD Candidate 2026
University of Georgia, College of Pharmacy
Erin Weippert PharmD Candidate 2025
University of Georgia, College of Pharmacy