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. 2022 Dec 21:9:1052071.
doi: 10.3389/fmed.2022.1052071. eCollection 2022.

Effect of prehospital transportation on 24-h fluid volume, a post hoc analysis of a multicenter, prospective, observational study on fluid volumes in patients with suspected infection

Marie Egebjerg Jensen  1 , Jens Aage Kølsen-Petersen  2   3 , Hans Kirkegaard  1   3   4 , Marie Kristine Jessen  1   2   3   4
Affiliations

Effect of prehospital transportation on 24-h fluid volume, a post hoc analysis of a multicenter, prospective, observational study on fluid volumes in patients with suspected infection

Marie Egebjerg Jensen et al. Front Med (Lausanne). .

Abstract

Introduction: Infections, including sepsis, are leading causes of death and fluid administration is part of the treatment. The optimal fluid therapy remains controversial. If the patient is transported by Emergency Medical Services (EMS), fluids can be initiated during transportation, which may result in increased overall fluid administration and fluid overload, which may be harmful. The aim of the study was to investigate the effect of EMS transportation on 24-h fluid administration in patients with suspected infection.

Methods: This is a post hoc study of a prospective, multicenter, observational study, conducted in three Danish Emergency Departments (EDs), 20 January-2 March 2020, aiming at describing fluid administration in patients with suspected infection. Patients were stratified into the groups: simple infection or sepsis, in accordance with SEPSIS-3-guidelines. The primary outcome of the current study was 24-h total fluid volume (oral and intravenous) stratified by transportation mode to the EDs.

Main results: Total 24-h fluids were registered for 734 patients. Patients with simple infection or sepsis arriving by EMS (n = 388, 54%) received mean 3,774 ml (standard deviation [SD]: 1900) and non-EMS received 3,627 ml (SD: 1568); mean difference (MD) was 303 ml [95% CI: 32; 573] adjusted for age, site, and total SOFA-score. Patients brought in by EMS received more intravenous fluids (MD: 621 ml [95% CI: 378; 864]) and less oral fluids (MD: -474 ml [95% CI: -616; -333]) than non-EMS patients.

Conclusion: Patients transported by EMS received more intravenous fluids and less oral fluids but overall, more fluid in total in the first 24-h than non-EMS after adjusting for age, site and SOFA-score.

Keywords: Emergency Medical Services (EMS); emergency department; fluid therapy; infection; sepsis.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Flow chart of this figure shows patient flow and transportation status.
See this image and copyright information in PMC

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