Abstract
BackgroundPositive fluid overload (FO) may cause adverse effect. This study retrospectively analyzed the relationship between early FO and in-hospital mortality in children with mechanical ventilation (MV) in pediatric intensive care unit (PICU).MethodsThis study retrospectively enrolled 309 children (ages 28 days to 16 years) receiving invasive MV admitted to the PICU of Xinhua Hospital from March 2014 to March 2019. Children receiving MV for less than 48 h were excluded. The FO in the first 3 days of MV was considered to the early FO. Patients were divided into groups according to early FO and survival to evaluate the associations of early FO, percentage FO(%FO) > 10%, and %FO > 20% with in-hospital mortality.ResultsA total of 309 patients were included. The mean early FO was 8.83 ± 8.81%, and the mortality in hospital was 26.2% (81/309). There were no significant differences in mortality among different FO groups (P = 0.053) or in early FO between survivors and non-survivors (P = 0.992). Regression analysis demonstrated that use of more vasoactive drugs, the presence of multiple organ dysfunction syndrome, longer duration of MV, and a non-operative reason for PICU admission were related to increased mortality (P < 0.05). Although early FO and %FO > 10% were not associated with in-hospital mortality (β = 0.030, P = 0.090, 95% CI = 0.995–1.067; β = 0.479, P = 0.153, 95% CI = 0.837–3.117), %FO > 20% was positively correlated with mortality (β = 1.057, OR = 2.878, P = 0.029, 95% CI = 1.116–7.418).ConclusionsThe correlation between early FO and mortality was affected by interventions and the severity of the disease, but %FO > 20% was an independent risk factor for in-hospital mortality in critically ill MV-treated children.
Highlights
IntroductionThis study retrospectively analyzed the relationship between early fluid overload (FO) and in-hospital mortality in children with mechanical ventilation (MV) in pediatric intensive care unit (PICU)
Positive fluid overload (FO) may cause adverse effect
The relationship between fluid overload (FO) and mortality reported by these studies is controversial, FO may be a predictor of death in critically ill children
Summary
This study retrospectively analyzed the relationship between early FO and in-hospital mortality in children with mechanical ventilation (MV) in pediatric intensive care unit (PICU). The relationship between fluid overload (FO) and mortality reported by these studies is controversial, FO may be a predictor of death in critically ill children. Most studies evaluate early FO as the ratio (expressed as a percentage) of the cumulative amount of fluid intake and output to weight on admission to hospital or PICU. In a retrospective study of 638 hospitalized patients receiving MV in the PICU [11], FO within 48 h of admission was not related to mortality, but it was related to deterioration of oxygenation index and prolonged MV duration in surviving patients, especially when the percentage of FO (%FO) was greater than or equal to 15%. Some studies directly defined early FO as %FO ≥ 10% and confirmed that %FO ≥ 10% often has adverse clinical consequences [6, 9, 12]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
