(1401) Fluid Administration PraCtices in AdulT Intensive Care Units in Saudi Arabia (FACT-ICU)

Introduction: Intravenous fluids are among the most common interventions in critically ill adult patients. However, inappropriate use of fluids occurs in approximately 20% of the patients. Volume overload is very common in critically ill patients, especially without a standardized volume management and removal approach. Current fluid administration practices in adult critically ill patients in Saudi Arabia are little known. Therefore, we aim to determine the current fluid practices in adult intensive care units (ICUs).

Methods: A national, observational, point prevalence study of critically ill patients was conducted on a single chosen day for each participating site for 3 months in 2022. The study included adult patients aged ≥ 18 years admitted to any adult ICUs and received any crystalloid or colloid fluid (bolus or maintenance) during the last 24 hours of the screening time point. The primary outcome was to describe current practices regarding ICU clinicians' choice and use of fluid administration.

Results: Overall, 65 ICUs within 18 institutions participated in the study. A total of 726 critically ill patients were screened, and 239 patients were enrolled. The median screening day from ICU admission was 6 days [2 -68]. The median age was 52 years [18 -100], and 58.2% were male. The median APACHE II was 17 [2 -51], and SOFA was 6 [2–17]. During the study period, 58.6% of the patients were on mechanical ventilation, and 9.38% were on renal replacement therapy. Crystalloid was administered as bolus and maintenance in 30.1% and 72.4% of the patients, respectively, while colloid was administered as bolus and maintenance in 13% and 10.5%, respectively. The mean total volume of crystalloid administered as bolus and maintenance was 1213 mL [300-6045] and 1778 mL [240-4800], respectively. Impaired perfusion was the most common reason for crystalloid administration (44.5%). The mean total volume of colloid administered as bolus and maintenance was 456 mL [100-2500].and 200 mL [50-400], respectively. Volume resuscitation in septic shock was the most common reason for colloid administration (37%).

Conclusions: Crystalloids are more frequently used fluid than colloids. Practice patterns of fluid administration in Saudi Arabia are consistent with international practices.