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  1. Article ; Online: Fluid accumulation in critically ill patients? Think beyond resuscitation fluids and cut the creep!

    Belloy, Lorraine / Van Regenmortel, Niels

    Intensive & critical care nursing

    2024  Volume 82, Page(s) 103642

    MeSH term(s) Humans ; Critical Illness ; Fluid Therapy ; Critical Care ; Resuscitation
    Language English
    Publishing date 2024-02-13
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 1105892-4
    ISSN 1532-4036 ; 0964-3397
    ISSN (online) 1532-4036
    ISSN 0964-3397
    DOI 10.1016/j.iccn.2024.103642
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  2. Article ; Online: Choice of creep or maintenance fluid type and their impact on total daily ICU sodium burden in critically ill patients: A systematic review and meta-analysis.

    Waskowski, Jan / Salvato, Sarah M / Müller, Martin / Hofer, Debora / van Regenmortel, Niels / Pfortmueller, Carmen A

    Journal of critical care

    2023  Volume 78, Page(s) 154403

    Abstract: Purpose: Maintenance and hidden/creep fluids are a major source of fluid and sodium intake in intensive care unit (ICU) patients. Recent research indicates that low versus high sodium content maintenance fluids could decrease fluid and sodium burden. We ...

    Abstract Purpose: Maintenance and hidden/creep fluids are a major source of fluid and sodium intake in intensive care unit (ICU) patients. Recent research indicates that low versus high sodium content maintenance fluids could decrease fluid and sodium burden. We conducted a systematic review (SR) with meta-analysis to summarize the impact of maintenance fluid choice on total daily sodium in ICU patients.
    Materials and methods: Systematic literature search in Pubmed, Embase, the Cochrane Library and the.
    Clinical trials registry: Only controlled clinical trials were included.
    Exclusion criteria: trials on resuscitation fluids, performed in the emergency department only and in pediatric patients. Primary objective was the reduction in mean total sodium intake with low versus high sodium content maintenance/creep fluids.
    Results: Five studies (1105 patients) were included. Heterogeneity was high.Risk of bias was moderate. Mean daily sodium reduction was 117 mmol (95%Confidence Interval [CI] -174; -59; p < 0.001) with low versus high sodium content maintenance/creep fluids. Incidence of hyperchloremia was lower (OR 0.26; 95%CI 0.1; 0.64) with low sodium. There were no differences in the incidences of hyper-/hyponatremia and fluid balances.
    Conclusion: Using low sodium content maintenance/creep fluids substantially reduces daily sodium burden in adult ICU patients. Significant knowledge/research gaps exist regarding relevance and safety.
    Trial registration: PROSPERO 2022 CRD42022300577 (February 2022).
    MeSH term(s) Adult ; Humans ; Child ; Sodium ; Critical Illness ; Hyponatremia ; Intensive Care Units ; Sodium, Dietary
    Chemical Substances Sodium (9NEZ333N27) ; Sodium, Dietary
    Language English
    Publishing date 2023-08-29
    Publishing country United States
    Document type Meta-Analysis ; Systematic Review ; Journal Article
    ZDB-ID 632818-0
    ISSN 1557-8615 ; 0883-9441
    ISSN (online) 1557-8615
    ISSN 0883-9441
    DOI 10.1016/j.jcrc.2023.154403
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  3. Article ; Online: Hypotonic or isotonic maintenance fluids for paediatric patients: the never-ending story.

    Langer, Thomas / Malbrain, Manu / Van Regenmortel, Niels

    Anaesthesiology intensive therapy

    2020  Volume 52, Issue 5, Page(s) 357–358

    MeSH term(s) Child ; Evidence-Based Medicine ; Fluid Therapy/methods ; Humans ; Hyponatremia/etiology ; Hypotonic Solutions/adverse effects ; Hypotonic Solutions/therapeutic use ; Infusions, Intravenous ; Isotonic Solutions/adverse effects ; Isotonic Solutions/therapeutic use
    Chemical Substances Hypotonic Solutions ; Isotonic Solutions
    Language English
    Publishing date 2020-10-22
    Publishing country Poland
    Document type Editorial
    ISSN 1731-2531
    ISSN (online) 1731-2531
    DOI 10.5114/ait.2020.101362
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  4. Article ; Online: Don't lose sight of maintenance fluids' main role: to provide free water!

    Van Regenmortel, Niels / Jorens, Philippe G

    Intensive care medicine

    2020  Volume 46, Issue 5, Page(s) 1074–1076

    MeSH term(s) Double-Blind Method ; Fluid Therapy ; Humans ; Sodium ; Thoracic Surgery ; Water
    Chemical Substances Water (059QF0KO0R) ; Sodium (9NEZ333N27)
    Language English
    Publishing date 2020-03-11
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 80387-x
    ISSN 1432-1238 ; 0340-0964 ; 0342-4642 ; 0935-1701
    ISSN (online) 1432-1238
    ISSN 0340-0964 ; 0342-4642 ; 0935-1701
    DOI 10.1007/s00134-020-05989-5
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  5. Article: Correction: Intravenous fluid therapy in patients with severe acute pancreatitis admitted to the intensive care unit: a narrative review.

    Crosignani, Andrea / Spina, Stefano / Marrazzo, Francesco / Cimbanassi, Stefania / Malbrain, Manu L N G / Van Regenmortel, Niels / Fumagalli, Roberto / Langer, Thomas

    Annals of intensive care

    2023  Volume 13, Issue 1, Page(s) 51

    Language English
    Publishing date 2023-06-14
    Publishing country Germany
    Document type Published Erratum
    ZDB-ID 2617094-2
    ISSN 2110-5820
    ISSN 2110-5820
    DOI 10.1186/s13613-023-01149-2
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  6. Article ; Online: Maintenance Fluids for Children: Hypotonic Fluids Are Still the Best Choice.

    Mattheij, Marjolein / Van Regenmortel, Niels

    Pediatric emergency care

    2016  Volume 32, Issue 2, Page(s) e4

    MeSH term(s) Fluid Therapy ; Humans ; Hypotonic Solutions/therapeutic use ; Isotonic Solutions/therapeutic use
    Chemical Substances Hypotonic Solutions ; Isotonic Solutions
    Language English
    Publishing date 2016-02
    Publishing country United States
    Document type Comment ; Letter
    ZDB-ID 632588-9
    ISSN 1535-1815 ; 0749-5161
    ISSN (online) 1535-1815
    ISSN 0749-5161
    DOI 10.1097/PEC.0000000000000711
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  7. Article ; Online: Inhaled liposomal amphotericin-B as a prophylactic treatment for COVID-19-associated pulmonary aspergillosis/aspergillus tracheobronchitis.

    Van Ackerbroeck, Sofie / Rutsaert, Lynn / Roelant, Ella / Dillen, Kathleen / Wauters, Joost / Van Regenmortel, Niels

    Critical care (London, England)

    2021  Volume 25, Issue 1, Page(s) 298

    MeSH term(s) Administration, Inhalation ; Aged ; Amphotericin B/administration & dosage ; Amphotericin B/pharmacology ; Amphotericin B/therapeutic use ; Aspergillosis/drug therapy ; Aspergillosis/epidemiology ; Aspergillosis/prevention & control ; Belgium/epidemiology ; COVID-19/complications ; COVID-19/epidemiology ; Cohort Studies ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies
    Chemical Substances liposomal amphotericin B ; Amphotericin B (7XU7A7DROE)
    Language English
    Publishing date 2021-08-19
    Publishing country England
    Document type Letter ; Observational Study
    ZDB-ID 2041406-7
    ISSN 1466-609X ; 1364-8535
    ISSN (online) 1466-609X
    ISSN 1364-8535
    DOI 10.1186/s13054-021-03728-w
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  8. Article ; Online: Zwanenzang van ziekmakend zout.

    Elbers, Paul W G / Kooter, Jos / van Regenmortel, Niels

    Nederlands tijdschrift voor geneeskunde

    2018  Volume 162

    Abstract: We previously suggested that choosing balanced solutions over normal saline for fluid therapy might benefit patients. After all, administration of NaCl 0.9% invokes metabolic acidosis and hyperchloraemia which was linked to renal failure and mortality in ...

    Title translation Abnormal saline's swan song.
    Abstract We previously suggested that choosing balanced solutions over normal saline for fluid therapy might benefit patients. After all, administration of NaCl 0.9% invokes metabolic acidosis and hyperchloraemia which was linked to renal failure and mortality in retrospective studies. Two large randomized controlled clinical trials now confirm this signal. Both in intensive care patients and in the setting of emergency medicine, balanced solutions were shown to reduce the incidence of MAKE30, a composite end point of hospital mortality and indices of renal failure. In addition, predefined subgroup analysis revealed increased mortality for normal saline in intensive care patients with sepsis. Even though the effect size is small in both studies, this evidence against normal saline is hard to ignore, given the immense number of patients who receive NaCl 0.9% worldwide. Therefore, clinical medicine may shortly witness the quiet disappearance of normal saline.
    MeSH term(s) Critical Care ; Electrolytes/administration & dosage ; Electrolytes/adverse effects ; Fluid Therapy/adverse effects ; Fluid Therapy/methods ; Hospital Mortality ; Humans ; Randomized Controlled Trials as Topic ; Retrospective Studies ; Ringer's Lactate/administration & dosage ; Ringer's Lactate/adverse effects ; Saline Solution/administration & dosage ; Saline Solution/adverse effects ; Sepsis/therapy
    Chemical Substances Electrolytes ; Ringer's Lactate ; Saline Solution ; Plasmalyte A (97397-05-2)
    Language Dutch
    Publishing date 2018-06-07
    Publishing country Netherlands
    Document type Journal Article ; Review
    ZDB-ID 82073-8
    ISSN 1876-8784 ; 0028-2162
    ISSN (online) 1876-8784
    ISSN 0028-2162
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  9. Article: Intravenous fluid therapy in patients with severe acute pancreatitis admitted to the intensive care unit: a narrative review.

    Crosignani, Andrea / Spina, Stefano / Marrazzo, Francesco / Cimbanassi, Stefania / Malbrain, Manu L N G / Van Regenmortel, Niels / Fumagalli, Roberto / Langer, Thomas

    Annals of intensive care

    2022  Volume 12, Issue 1, Page(s) 98

    Abstract: Patients with acute pancreatitis (AP) often require ICU admission, especially when signs of multiorgan failure are present, a condition that defines AP as severe. This disease is characterized by a massive pancreatic release of pro-inflammatory cytokines ...

    Abstract Patients with acute pancreatitis (AP) often require ICU admission, especially when signs of multiorgan failure are present, a condition that defines AP as severe. This disease is characterized by a massive pancreatic release of pro-inflammatory cytokines that causes a systemic inflammatory response syndrome and a profound intravascular fluid loss. This leads to a mixed hypovolemic and distributive shock and ultimately to multiorgan failure. Aggressive fluid resuscitation is traditionally considered the mainstay treatment of AP. In fact, all available guidelines underline the importance of fluid therapy, particularly in the first 24-48 h after disease onset. However, there is currently no consensus neither about the type, nor about the optimal fluid rate, total volume, or goal of fluid administration. In general, a starting fluid rate of 5-10 ml/kg/h of Ringer's lactate solution for the first 24 h has been recommended. Fluid administration should be aggressive in the first hours, and continued only for the appropriate time frame, being usually discontinued, or significantly reduced after the first 24-48 h after admission. Close clinical and hemodynamic monitoring along with the definition of clear resuscitation goals are fundamental. Generally accepted targets are urinary output, reversal of tachycardia and hypotension, and improvement of laboratory markers. However, the usefulness of different endpoints to guide fluid therapy is highly debated. The importance of close monitoring of fluid infusion and balance is acknowledged by most available guidelines to avoid the deleterious effect of fluid overload. Fluid therapy should be carefully tailored in patients with severe AP, as for other conditions frequently managed in the ICU requiring large fluid amounts, such as septic shock and burn injury. A combination of both noninvasive clinical and invasive hemodynamic parameters, and laboratory markers should guide clinicians in the early phase of severe AP to meet organ perfusion requirements with the proper administration of fluids while avoiding fluid overload. In this narrative review the most recent evidence about fluid therapy in severe AP is discussed and an operative algorithm for fluid administration based on an individualized approach is proposed.
    Language English
    Publishing date 2022-10-17
    Publishing country Germany
    Document type Journal Article ; Review
    ZDB-ID 2617094-2
    ISSN 2110-5820
    ISSN 2110-5820
    DOI 10.1186/s13613-022-01072-y
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  10. Article ; Online: Is it feasible to measure intra-abdominal pressure using a balloon-tipped rectal catheter? Results of a validation study.

    Staelens, Anneleen S / Heymans, Ann / Christiaens, Sigrid / Van Regenmortel, Niels / Gyselaers, Wilfried / Malbrain, Manu L N G

    Journal of clinical monitoring and computing

    2022  Volume 37, Issue 1, Page(s) 287–296

    Abstract: The gold standard to measure intra-abdominal pressure (IAP) is intra-vesical measurement via the urinary bladder. However, this technique is restricted in ambulatory settings because of the risk of iatrogenic urinary tract infections. Rectal IAP ... ...

    Abstract The gold standard to measure intra-abdominal pressure (IAP) is intra-vesical measurement via the urinary bladder. However, this technique is restricted in ambulatory settings because of the risk of iatrogenic urinary tract infections. Rectal IAP measurements (IAP
    MeSH term(s) Humans ; Pressure ; Catheterization ; Abdominal Cavity ; Urinary Bladder ; Catheters ; Abdomen
    Language English
    Publishing date 2022-07-30
    Publishing country Netherlands
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1418733-4
    ISSN 1573-2614 ; 1387-1307 ; 0748-1977
    ISSN (online) 1573-2614
    ISSN 1387-1307 ; 0748-1977
    DOI 10.1007/s10877-022-00890-6
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