Fluid Overload Revisited

Fluid Overload Revisited

Iatrogenic hemodilution: a possible source for avoidable transfusion? - A Perel

Learning Points

The quest for the optimal Hb threshold for RBC transfusion seems a never-ending journey

Using same threshold for all patients is imprecision medicine.

Restrictive v Liberal transfusion has been extensively researched but ideal thresholds for transfusion are not known.

Dilutional anaemia may be a more significant factor.

Iatrogenic haemodilution may paradoxically decrease the DO2 due to reduced carriage in oxygenated haemoglobin.

References

http://bit.ly/2A5o5iH

http://bit.ly/2A2QQwK

http://bit.ly/2A8jBpz

Meta-analysis of fluid overload - J Silversides

Learning Points

Does oedema associated with +ve fluid balance contribute to organ dysfunction and mortality? Seems to in ARDS and sepsis.

Positive fluid balance is preventable - comes from maintenance fluid and drug infusions. Both of which are modifiable.

Programme of research - SR, pilot RCT, multicentre RCT

RADAR-2 pilot RCT, n=180 in 5 NI sites - starting next year

References

https://t.co/cYu0qCT23c

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