Objective
To compare echocardiography‑guided versus clinically guided fluid resuscitation regarding mortality of critically ill patients in ICU.
Patients and methods
This randomized controlled trial was carried out on 120 patients with circulatory shock. Demographic, clinical, and routine laboratory data were recorded. Eligible patients were randomly assigned to either echocardiography‑guided fluid resuscitation or clinically guided fluid resuscitation. Fluid responsiveness was defined as either left ventricular outflow tract‑time velocity integral respiratory variation by 12% or an increase in left ventricular outflow tract‑time velocity integral by 12% after 250 ccs of normal saline challenge.
Results
Echocardiography‑guided resuscitation cases have significantly lower hospital mortality (30 vs. 43% in controls; P = 0.001), intubation and mechanical ventilation rates (7.87 ± 0.63 vs. 4.48 ± 0.38 days in controls; P = 0.01). Moreover, cases have a significantly lower amount of fluid (26 800 vs. 50502 ml in the control group20), with significantly lower net cost [13.4$ (214 EGP) vs. vs 25.11 $ (401 EGP) in the controls; P = 0.000 in controls; P = 0.00].
Conclusions
Echocardiography‑guided fluid resuscitation appears to have lower hospital mortality, hospital morbidities, and ICU cost.