Effectiveness of daily fluid balance charting in comparison to the measurement of body weight when used in guiding fluid therapy for critically ill adult patients: a systematic review protocol.

Abstract

Review objective The objective of this review is to determine the effectiveness of daily fluid balance charting in comparison to the measurement of body weight when used in guiding fluid therapy for critically ill adult patients. More specifically, the objectives are to identify: The accuracy and utility of estimating body fluid status by charting daily fluid balance totals The accuracy and utility of estimating body fluid status by daily body weight measurements The utility of both approaches for estimation of changes in body fluid status Any special considerations required for patients who are oliguric and at risk of fluid overload Inclusion criteria Types of participants This review will consider studies involving critically ill adult patients (18 years and over) that have body fluid status evaluated according to fluid balance and measurement of body weight. Of particular interest will be studies which include patients who are susceptible to the consequences of fluid overload. The studies may include patients with severe acute kidney injury requiring renal replacement therapy, patients with cardiogenic shock who develop significant heart failure and patients with acute lung injury who require mechanical ventilation. Studies that focus on the intensive care unit pediatric or neonatal population will be excluded from the review process. Anatomical, physiological and biochemical differences in pediatric and neonatal studies make comparisons of findings difficult to extrapolate when making recommendations on clinical practice to the adult population for this particular issue. Types of intervention Only non-invasive methods of estimating body fluid status will be reviewed. The primary focus will be on studies that have evaluated the charting of inputs and outputs and daily fluid balance totals to estimate body fluid status. Types of comparator The comparator will be the alternative non-invasive method of measuring daily body weight for the estimation of body fluid status. Types of outcome measures The review will consider studies that include, but are not restricted to, the following outcome measures: Duration of hospitalization, as defined by number of day’s in intensive care unit and as a ward patient Number of hour’s patient intubated and required mechanical ventilation Patient survival post transfer from TRUNCATED AT 350 WORDS