Measure ID
FLUID-01-C
Domain
Description

Percentage of adult cardiac cases in which colloids were not administered intraoperatively.

Measure Type
Process
Available for Provider Feedback
Yes
Threshold
Not applicable - Informational only
Rationale

There is a lack of consistent evidence to suggest improved survival with the use of colloids as compared to crystalloids in the surgical population. Colloids are also more expensive than crystalloids. It is the expectation that providers will uphold the ASA’s Choosing Wisely program by avoiding colloids and using crystalloid instead when appropriate.

Measure Time Period
Inclusions

Adult cardiac patients as determined by Procedure Type: Cardiac value codes >0

Exclusions
Success Criteria

Colloids are not administered during the case.

Other Measure Details

*This measure will include only valid MPOG cases as defined by the Is Valid Case phenotype.

Risk Adjustment

Not applicable

Provider Attribution

The provider signed in at the time of the colloid administration.

MPOG Concept Used

Colloids

  • 10018  Albumin 5%
  • 10458  Hetastarch
  • 10459  Pentastarch
  • 10601  Hydroxyethyl Starch 130/0.4 6% in 0.9% Saline (Voluven)
  • 10605  Hydroxyethyl Starch 6% in Lactated Ringers (Hextend)

Patient Position 

  • 50136  Positioning - Patient Position
  • 50137  Positioning - Patient positioned in left lateral decubitus position
  • 50818  Patient positioned in right lateral decubitus position

Blood Administration

  • 10489  Packed Red Blood Cells - Autologous
  • 10490  Packed Red Blood Cells - Homologous
  • 10616  Packed Red Blood Cells - Unknown Type

Patient Diagnosis

  • 10500  Ascites

Estimated Blood Loss (EBL) 

  • 10499  EBL
MPOG Phenotypes Used
References
  1. Nolan JP, Mythen MG.  Hydroxyethyl starch: here today, gone tomorrow.  British Journal of Anaesthesia 2013, 111(3): 321–4.  doi:10.1093/bja/aet294.
  2. Perel P, Roberts I, Pearson M.  Colloids versus crystalloids for fluid resuscitation in critically ill patients (Review). The Cochrane Collaboration. (2009) Published by JohnWiley & Sons, Ltd.
  3. Schick M, Isbary J, Stuber T, Brugger J, Stumpner J, Schkegel N, Roewer N, Eichelbronner O, Wunder C.  Effects of crystalloids and colloids on liver and intestine microcirculation and function in cecal ligation and puncture induced septic rodents. BMC Gastroenterology 2012, 12:179.  http://www.biomedcentral.com/1471-230X/12/179.
  4. Youssef MA, Al-Inany HG, Evers JL, Aboulghar M. Intra-venous fluids for the prevention of severe ovarian hyperstimulation syndrome. Cochran Database Systematic Reviews 2011, 16(2): CD001302. Doi: 10.1002/14651858.CD001302.pub2.
  5. Ryhammer, Pia Katarina, Mariann Tang, Joachim Hoffmann-Petersen, Dovile Leonaviciute, Jacob Greisen, Marie Storebjerg Gissel, and Carl-Johan Jakobsen. 2017. “Colloids in Cardiac Surgery-Friend or Foe?” Journal of Cardiothoracic and Vascular Anesthesia 31 (5): 1639–48.
Measure Authors
 Measure Author  Institution
 Mike Mathis, MD  University of Michigan
 Sachin Kheterpal, MD  University of Michigan
 Nirav Shah, MD  University of Michigan
 Jamie Osborne, RN  University of Michigan
 Genevive Bell  University of Michigan
 MPOG Quality Committee  

 

Measure Reviewer(s)
Next Review: 2024
 Date Reviewed  QC Presentation  Reviewer  Institution  Summary  QC Vote
 TBD  TBD  TBD  TBD  TBD  TBD

 

Version
Published Date: 2015
Date Criteria Revision
3/16/2022  Inclusion Modified to use new Cardiac phenotype
9/1/2015   Initial Publication