Title |
A positive fluid balance is an independent prognostic factor in patients with sepsis
|
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Published in |
Critical Care, December 2015
|
DOI | 10.1186/s13054-015-0970-1 |
Pubmed ID | |
Authors |
Angela Acheampong, Jean-Louis Vincent |
Abstract |
Intravenous fluid administration is an essential component of sepsis management, but a positive fluid balance has been associated with worse prognosis. We analyzed whether a positive fluid balance and its persistence over time was an independent prognostic factor in septic patients. We prospectively studied fluid intake and output for 7 days in 173 consecutive adult patients treated for sepsis in our Department of Intensive Care. Of the 173 patients, 59 died (34 %). Mean daily fluid intake was higher in non-survivors than in survivors (59 ± 24 ml/kg vs. 48 ± 23 ml/kg, p = 0.03), but output volumes were similar. As a result, the daily fluid balance was more than twice as large in the non-survivors as in the survivors (29 ± 22 vs. 13 ± 19 ml/kg, p < 0.001). Persistence of a positive fluid balance over time was associated with increased mortality. Using a multivariable time-dependent Cox model, a positive fluid balance was independently associated with higher mortality (adjusted hazard ratio 1.014 [1.007-1.022] per ml/kg increase, p < 0.001). Persistence of a positive daily fluid balance over time was quite strongly associated with a higher mortality rate in septic patients. |
X Demographics
Geographical breakdown
Country | Count | As % |
---|---|---|
United Kingdom | 48 | 17% |
United States | 41 | 14% |
Spain | 14 | 5% |
Mexico | 8 | 3% |
Australia | 8 | 3% |
Argentina | 4 | 1% |
Colombia | 4 | 1% |
Ecuador | 4 | 1% |
Italy | 4 | 1% |
Other | 38 | 13% |
Unknown | 116 | 40% |
Demographic breakdown
Type | Count | As % |
---|---|---|
Members of the public | 196 | 68% |
Practitioners (doctors, other healthcare professionals) | 63 | 22% |
Scientists | 25 | 9% |
Science communicators (journalists, bloggers, editors) | 5 | 2% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
United States | 2 | <1% |
Turkey | 1 | <1% |
Egypt | 1 | <1% |
Brazil | 1 | <1% |
Japan | 1 | <1% |
Mexico | 1 | <1% |
Unknown | 412 | 98% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Other | 57 | 14% |
Student > Postgraduate | 47 | 11% |
Student > Master | 42 | 10% |
Researcher | 34 | 8% |
Student > Doctoral Student | 29 | 7% |
Other | 107 | 26% |
Unknown | 103 | 25% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 246 | 59% |
Nursing and Health Professions | 15 | 4% |
Pharmacology, Toxicology and Pharmaceutical Science | 14 | 3% |
Agricultural and Biological Sciences | 5 | 1% |
Engineering | 5 | 1% |
Other | 20 | 5% |
Unknown | 114 | 27% |