Effectiveness of daily fluid balance charting versus body weight measurement as a guide for fluid administration therapy after cardiac surgery

Mohammed Elgazzar; Ehab  Said; Osama  Sanad; Gamal  Lotfy; Mahmoud  Shafie

doi:10.35810/ects.v3i5.196

Mohammed Elgazzar Department of Cardiothoracic Surgery, Faculty of Medicine, Banha University, Banha, Egypt
Ehab Said Department of Anaesthesia, Faculty of Medicine, Banha University, Banha, Egypt
Osama Sanad Department of Cardiology, Faculty of Medicine, Benha University, Benha, Egypt
Gamal Lotfy Department of Intensive Care, El-Mehalla General Hospital, Egypt
Mahmoud Shafie Department of Cardiothoracic Surgery, Faculty of Medicine, Banha University, Banha, Egypt

DOI: https://doi.org/10.35810/ects.v3i5.196

Keywords: Fluid balance, Body water, Fluid administration therapy

Abstract

Background: Several studies have established a link between fluid overload and an increased risk of death. After cardiac surgery, patients' fluid status should be assessed at close intervals. A daily fluid balance (FB) has several limitations. This study aims to determine the agreement and correlation between fluid status changes calculated by the daily fluid balance through the conventional charting approach and body weight (BW) change using beds equipped with weighing scales.

Methods: This is a prospective observational study that included 50 patients who underwent cardiac surgeries. It evaluates the precision and usefulness of determining body fluid status and requirements using daily fluid balance and body weight measurements.

Results: The mean age of the study group was 52.9 ±10.44 years. The mean weight, height, and BMI were 87.1 ± 16.68 Kg, 170.4 ± 4.59 cm, and 30.12 ± 6.21 kg/m². The mean duration of mechanical ventilation was 9.5 ±3.73 h. Mean ICU and hospitalization times were 2.4 ± 0.67 and 6.3 ± 1.36 days, respectively. The mean cumulative fluid balance was 0.52 ± 3.21 L, and the overall change in body weight (discharge weight − admission weight) was 0.55 ± 2.89 kg. There was a highly significant positive correlation between overall bodyweight and cumulative fluid balance (r- coefficeient= 0.947, p-value <0.001).

Conclusion: Bodyweight measured by weight-enabled beds could seem sufficiently robust or accurate to replace daily FB in ICU post open heart. Such measurement might be used to monitor overall changes in BW in patients with a prolonged ICU stay.