BaSICS Trial: Slower IV Bolus Does Not Affect Mortality in Critical Care

Critically ill patients who received a slower fluid infusion had no decrease in mortality when compared to those receiving an infusion at the typical infusion speed, according to results of the BaSICS trial (ClinicalTrials.gov Identifier: NCT02875873), which were recently published in the Journal of the American Medical Association.

Critically ill patients across 75 intensive care units in Brazil who required fluid challenges were randomized to receive infusion rates of either 333 mL per hour for the slow infusion group or 999 mL per hour for the control group. The primary outcome of interest was 90-day mortality between the 2 groups.

Among the 11,052 critically ill patients requiring at least 1 fluid challenge, 10,520 (95.2%) were included in the study analysis. The average age was 61.1 years and 44.2% of the study population were women. Following randomization, 5538 patients were assigned the slower rate while 5514 were assigned to the control group. By day 90, mortality was 26.6% in the slower rate group compared to 27.0% in the control group. There was no significant interaction between infusion rate and mortality.

The study authors wrote, “Among patients in the intensive care unit requiring fluid challenges, infusing at a slower rate compared with a faster rate did not reduce 90-day mortality.” They added, “These findings do not support the use of a slower infusion rate.”

Disclosure: Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.

Reference

Zampieri FG, Machado FR, Biondi RS, et al; BaSICS investigators and the BRICNet members. Effect of slower vs faster intravenous fluid bolus rates on mortality in critically ill patients: the BaSICS randomized clinical trial. JAMA. 2021;326(9):830-838. doi:10.1001/jama.2021.11444