A comparison of compliance in the estimation of body fluid status using daily fluid balance charting and body weight changes during continuous renal replacement therapy
Australian Critical Care
Elsevier Ireland Ltd
School of Nursing and Midwifery
The survival and recovery of critically ill patients is adversely affected by the presence of fluid overload. The transition between fluid resuscitation and restoration of homoeostasis is a critical period for the seriously ill patient and of particular importance for survival in patients with acute kidney injury who are at increased risk of developing fluid overload.3 This has led to a renewed interest in methods used to evaluate body fluid status. The charting of daily fluid balances is one method commonly used in the intensive care unit (ICU) when assessing patients' body fluids. Errors in daily fluid balance totals have been shown to occur and can accumulate., ,  Over time, this increases the inaccuracy of cumulative fluid balance totals.7 In view of the potential for errors in the calculation of fluid balance, measurement of body weight changes is another approach commonly used in assessing fluid status. Similar to the reported association of worse patient outcomes with charting a positive fluid balance,8 more weight gain was shown in one study to correlate with increases in ICU mortality, duration of mechanical ventilation, and length of stay (LOS).9 It is suggested that measurement of daily body weight change can provide a more accurate method of monitoring body fluid status.,  Monitoring changes in body weight is different to the charting of inputs and outputs as body weight provides a “physical” rather than a “calculated” picture of the patient's body fluid status.