2.50
Hdl Handle:
http://hdl.handle.net/10755/161432
Type:
Presentation
Title:
Relationship between fluid balance & weaning in older critically ill patients
Abstract:
Relationship between fluid balance & weaning in older critically ill patients
Conference Sponsor:Midwest Nursing Research Society
Conference Year:2003
Author:Epstein, Carol
P.I. Institution Name:Case Western Reserve University
Contact Address:Frances Payne Bolton School of Nursing,, 10900 Euclid Avenue, Cleveland, OH, 44106, USA
Co-Authors:Joel R. Peerless; Hanem Fathalla Mohamed; Eric R. Wrenn; Matthew E. Kuestner
Purpose: This study examined changes in daily fluid balance (DFB), net cumulative fluid balance (CFB), and body weight (BW) in trauma and surgical older adults as they transitioned to long-term mechanical ventilation (LTMV). Conceptual framework: The Weaning Continuum Model was developed by the AACN 3rd National Study Group on Weaning from Mechanical Ventilation. Little is known about fluid-based parameters related to successful weaning. Subjects: The sample consisted of 39 patients (>60 years) admitted to the surgical intensive care unit of a Level I Trauma Center. Methods: Changes in DFB, CFB, and BW were monitored for 14 days, and were compared between patients who weaned (PW) and did not wean (NW). Distributions of variables were examined for normality, appropriate statistical tests were used, and results reported as mean values + standard deviation (SD) in liters (L). Results: Upon study entry, the DFB of PW (n=28, 72%) was -0.394+1.4L, significantly lower than that of NW (1.3+1.6L) (t-3.180, p=.003) and the net CFB of PW was 5.6+9.6L, significantly lower than that of NW (18.3+23.8L) (Z-3.614, p=.0001). While the final net CFB of PW had increased to 9.4+10.2L, the final net CFB of NW rose to a significantly higher level (29.3+26L) (Z-5.08,p=.0001). No significant differences in BW between PW and NW were found. Acceptable 95% confidence intervals for weight and a medium effect size of .50 were present; however, power was limited by a small sample size. Conclusions: Fluid volume overload is present in older surgical and trauma patients who have newly transitioned to LTMV, particularly those who require extended LTMV. While DFB differentiates PW from NW, the net CFB provides a fuller picture of the degree to which fluid volume excess accrues over time. Further study with a larger sample is needed to examine the relationship between body weight and weaning from MV. AN: MN030299
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Midwest Nursing Research Society

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleRelationship between fluid balance & weaning in older critically ill patientsen_GB
dc.identifier.urihttp://hdl.handle.net/10755/161432-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Relationship between fluid balance &amp; weaning in older critically ill patients </td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Midwest Nursing Research Society</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2003</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Epstein, Carol</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Case Western Reserve University</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">Frances Payne Bolton School of Nursing,, 10900 Euclid Avenue, Cleveland, OH, 44106, USA</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Joel R. Peerless; Hanem Fathalla Mohamed; Eric R. Wrenn; Matthew E. Kuestner </td></tr><tr><td colspan="2" class="item-abstract">Purpose: This study examined changes in daily fluid balance (DFB), net cumulative fluid balance (CFB), and body weight (BW) in trauma and surgical older adults as they transitioned to long-term mechanical ventilation (LTMV). Conceptual framework: The Weaning Continuum Model was developed by the AACN 3rd National Study Group on Weaning from Mechanical Ventilation. Little is known about fluid-based parameters related to successful weaning. Subjects: The sample consisted of 39 patients (&gt;60 years) admitted to the surgical intensive care unit of a Level I Trauma Center. Methods: Changes in DFB, CFB, and BW were monitored for 14 days, and were compared between patients who weaned (PW) and did not wean (NW). Distributions of variables were examined for normality, appropriate statistical tests were used, and results reported as mean values + standard deviation (SD) in liters (L). Results: Upon study entry, the DFB of PW (n=28, 72%) was -0.394+1.4L, significantly lower than that of NW (1.3+1.6L) (t-3.180, p=.003) and the net CFB of PW was 5.6+9.6L, significantly lower than that of NW (18.3+23.8L) (Z-3.614, p=.0001). While the final net CFB of PW had increased to 9.4+10.2L, the final net CFB of NW rose to a significantly higher level (29.3+26L) (Z-5.08,p=.0001). No significant differences in BW between PW and NW were found. Acceptable 95% confidence intervals for weight and a medium effect size of .50 were present; however, power was limited by a small sample size. Conclusions: Fluid volume overload is present in older surgical and trauma patients who have newly transitioned to LTMV, particularly those who require extended LTMV. While DFB differentiates PW from NW, the net CFB provides a fuller picture of the degree to which fluid volume excess accrues over time. Further study with a larger sample is needed to examine the relationship between body weight and weaning from MV. AN: MN030299 </td></tr></table>en_GB
dc.date.available2011-10-26T23:21:15Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T23:21:15Z-
dc.description.sponsorshipMidwest Nursing Research Societyen_GB
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