Implementing a Goal-Directed Therapy Protocol for Fluid Resuscitation in the Cardiovascular Intensive Care Unit.

Journal Article (Journal Article)

Background

Balancing fluid administration and titration of vasoactive medications is critical to preventing postoperative complications in cardiac surgical patients.

Objective

To evaluate the impact of implementing a goal-directed therapy protocol in the cardiovascular intensive care unit on total intravenous fluids administered on the day of surgery, rates of acute kidney injury, and hospital length of stay.

Methods

A fluid resuscitation protocol using dynamic assessment of fluid responsiveness with stroke volume index was developed, and nurses were prepared for its implementation using simulation training.

Results

After implementation of the new protocol, the total amount of intravenous fluids administered on the day of surgery was significantly reduced (P = .003). There were no significant changes in hospital length of stay (P = .83) or rates of acute kidney injury (P = .86). There were significant increases in nurses' knowledge of (P < .001) and confidence in (P < .001) fluid resuscitation and titration of vasoactive medications after simulation training.

Conclusions

Use of a fluid resuscitation protocol resulted in a reduction in the amount of intravenous fluids administered on the day of surgery. The simulation training increased nurses' knowledge of and confidence in fluid resuscitation and titration of vasoactive medications.

Full Text

Duke Authors

Cited Authors

  • Brien, LD; Oermann, MH; Molloy, M; Tierney, C

Published Date

  • December 2020

Published In

Volume / Issue

  • 31 / 4

Start / End Page

  • 364 - 370

PubMed ID

  • 33313703

Electronic International Standard Serial Number (EISSN)

  • 1559-7776

International Standard Serial Number (ISSN)

  • 1559-7768

Digital Object Identifier (DOI)

  • 10.4037/aacnacc2020582

Language

  • eng