Please use this identifier to cite or link to this item: https://www.arca.fiocruz.br/handle/icict/44214

Type
Article
Copyright
Restricted access
Collections
Share

Statistics
Metadata
Show full item record
Article has an altmetric score of 8

AN INTERNATIONAL COMPARISON OF THE COST OF FLUID RESUSCITATION THERAPIES
Taylor, Colman et al. | Date Issued: 2020
Author
Taylor, Colman
Yang, Li
Finfer, Simon
Machado, Flavia R.
YouZhong, An
Billot, Laurent
Bloos, Frank
Bozza, Fernando A.
Cavalcanti, Alexandre Biasi
Correa, Maryam
Du, Bin
Hjortrup, Peter B.
McIntyre, Lauralyn
Saxena, Manoj
Schortgen, Frédérique
Watts, Nicola R.
Myburgh, John
Thompson, Kelly
Hammond, Naomi E.
Affilliation
The George Institute for Global Health. Critical Care Division. Sydney, Australia / University of New South Wales. Faculty of Medicine. Sydney, Australia.
The George Institute for Global Health. Critical Care Division. Sydney, Australia.
The George Institute for Global Health. Critical Care Division. Sydney, Australia / University of New South Wales. Faculty of Medicine. Sydney, Australia / Royal North Shore Hospital. Malcolm Fisher Department of Intensive Care Medicine. Sydney, Australia.
Federal University of Sao Paulo. Anesthesiology, Pain and Intensive Care Department. São Paulo, SP, Brazil.
Peking University People's Hospital. Department of Critical Care Medicine. Beijing, China.
University of New South Wales. Faculty of Medicine. Sydney, Australia / The George Institute for Global Health. Statistics Division. Sydney, Australia
Jena University Hospital. Department of Anesthesiology and Intensive Care Medicine. Jena, Germany.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil / Instituto D'Or de Pesquisa e Educação. Rio de Janeiro, RJ, Brasil.
Hospital do Coração. Instituto de Pesquisa HCor. São Paulo, SP, Brasil.
The George Institute for Global Health. Critical Care Division. Sydney, Australia / University of New South Wales. Faculty of Medicine. Sydney, Australia.
Peking Union Medical College Hospital. Medical Intensive Care Unit. Beijing, China.
Copenhagen University Hospital. Department of Intensive Care. Rigshospitalet, Denmark.
The Ottawa Hospital Research Institute. Department of Medicine. Ottawa, Canada.
The George Institute for Global Health. Critical Care Division. Sydney, Australia / University of New South Wales. Faculty of Medicine. Sydney, Australia / Bankstown Hospital. Department of Intensive Care. Bankstown, Australia.
Assistance Publique-Hôpitaux de Paris. Réanimation Médicale Groupe Hospitalier Henri Mondor. Créteil, France.
The George Institute for Global Health. Critical Care Division. Sydney, Australia / University of New South Wales. Faculty of Medicine. Sydney, Australia.
The George Institute for Global Health. Critical Care Division. Sydney, Australia / University of New South Wales. Faculty of Medicine. Sydney, Australia / St. George Hospital. Department of Intensive Care. Kograh, Australia.
The George Institute for Global Health. Critical Care Division. Sydney, Australia / University of New South Wales. Faculty of Medicine. Sydney, Australia.
The George Institute for Global Health. Critical Care Division. Sydney, Australia / University of New South Wales. Faculty of Medicine. Sydney, Australia.
Abstract
Objective: Fluid resuscitation is a ubiquitous intervention in the management of patients treated in the intensive care unit, which has implications for intensive care unit resourcing and budgets. Our objective was to calculate the relative cost of resuscitation fluids in several countries to inform future economic evaluations. Methods: We collected site-level data regarding the availability and cost of fluids as part of an international survey. We normalised costs to net present values using purchasing power parities and published inflation figures. Costs were also adjusted for equi-effective dosing based on intravascular volume expansion effectiveness and expressed as US dollars (USD) per 100 mL crystalloid equivalent. Results: A total of 187 sites had access to cost data. Between countries, there was an approximate six fold variation in the cost of crystalloids and colloids overall. The average cost for crystalloids overall was less than 1 USD per 100 mL. In contrast, colloid fluids had higher average costs (59 USD per 100 mL). After adjusting for equi-effective dosing, saline was ∼27 times less costly than albumin (saline: 0.6 USD per 100 mL crystalloid equivalent; albumin 4-5%: 16.4 USD; albumin 20-25%: 15.8 USD) and ∼4 times less costly than hydroxyethyl starch solution (saline: 0.6 USD; hydroxyethyl starch solution: 2.5 USD). Buffered salt solutions, such as compound sodium acetate solutions (e.g., Plasmalyte®), had the highest average cost of crystalloid fluids, costing between 3 and 4 USD per 100 mL. Conclusion: The cost of fluid varies substantially between fluid types and between countries, although normal (0.9%) saline is consistently less costly than colloid preparations and some buffered salt solutions. These data can be used to inform future economic evaluations of fluid preparations.
Keywords
Colloid
Cost
Crystalloid
Fluid resuscitation
Intensive care
 
Publisher
Elsevier
Citation
TAYLOR, Colman et al. An international comparison of the cost of fluid resuscitation therapies. Australian Critical Care, n. 20, p. 1-10, 2020.
DOI
10.1016/j.aucc.2020.06.001
ISSN
1036-7314