Intensive care nurses' self-reported practice of intravenous fluid bolus therapy

Glenn M. Eastwood, Leah Peck, Helen Young, Emily Paton, Neil J. Glassford, Ling Zhang, Guijun Zhu, Aiko Tanaka, Rinaldo Bellomo

Research output: Contribution to journalArticleResearchpeer-review

2 Citations (Scopus)

Abstract

Objective: To describe self-reported practice of fluid bolus therapy by intensive care nurses. Research methodology: Multi-choice questionnaire of intensive care nurses conducted in July, 2014. Setting: Major university tertiary referral centre. Findings: 141 (64%) intensive care nurses responded. The majority of respondents identified 4% albumin as the commonest fluid bolus type and stated a fluid bolus was 250. ml; however fluid bolus volume varied from 100. ml to 1000. ml. Hypotension was identified as the primary physiological trigger for a fluid bolus. In the hour following a fluid bolus for hypotension almost half of respondents expected an 'increase in mean arterial pressure of 0-10. mmHg'; for oliguria, >60% expected an 'increase in urinary output of '0.5-1. ml/kg/hour'; for low CVP, 50% expected 'an increase in CVP of 3-4. mmHg'; and, for tachycardia, 45% expected a 'decrease in heart rate of 11-20. beats/minute'. Finally, 7-10% of respondents were 'unsure' about the physiological response to a fluid bolus. Conclusion: Most respondents identified fluid bolus therapy to be at least 250. ml of 4% albumin given as quickly as possible; however, volumes from 100 to 1000. ml were also accepted. There was much uncertainty about the expected physiological response to fluid bolus therapy according to indication.

Original languageEnglish
Pages (from-to)352-358
Number of pages7
JournalIntensive & Critical Care Nursing
Volume31
Issue number6
DOIs
Publication statusPublished - 1 Dec 2015
Externally publishedYes

Keywords

  • Acute care nursing
  • Bolus fluid therapy
  • Decision-making
  • Fluid resuscitation
  • Intravenous fluid

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