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. 2015 Dec;19(12):708-13.
doi: 10.4103/0972-5229.171356.

Impact of positive fluid balance on mortality and length of stay in septic shock patients

Wachiraporn Koonrangsesomboon  1 , Bodin Khwannimit  2
Affiliations

Impact of positive fluid balance on mortality and length of stay in septic shock patients

Wachiraporn Koonrangsesomboon et al. Indian J Crit Care Med. 2015 Dec.

Abstract

Background: Fluid management is important in critically patients. The aim of this study was to determine the relationship between fluid balance and adverse outcomes of septic shock.

Methods: A retrospective study was conducted in the medical Intensive Care Unit (ICU) of a tertiary university hospital in Thailand, over a 7-year period.

Results: A total of 1048 patients with an ICU mortality rate of 47% were enrolled. The median cumulative fluid intake at 24, 48, and 72 h from septic shock onset were 4.2, 7.7, and 10.5 L, respectively. Nonsurvivors had a significantly higher median cumulative fluid intake at 24, 48, and 72 h (4.6 vs. 3.9 L, 8.2 vs. 7.1 L, and 11.4 vs. 9.9 L, respectively, P < 0.001 for all). Nonsurvivors also had a significantly higher cumulative and mean fluid balance within 72 h (5.4 vs. 4.4 L and 2.8 vs. 1.6 L, P < 0.001 for both). In multivariate logistic regression analysis, mean fluid balance quartile within 72 h, was independently associated with an increase in ICU and hospital mortality. Quartile 3 and 4 have statistically significant increases in mortality compared with quartile 1 (odds ratio [95% confidence interval] 3.04 [1.9-4.48] and 4.16 [2.49-6.95] for ICU mortality and 2.75 [1.74-4.36] and 3.16 [1.87-5.35] for hospital mortality, respectively, P < 0.001 for all). In addition, the higher amount of mean fluid balance was associated with prolonged ICU stays.

Conclusions: Positive fluid balance over 3 days is associated with increased ICU and hospital mortality along with prolonged ICU stays in septic shock patients.

Keywords: Fluid; fluid balance; mortality; prognostic factor; septic shock.

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Figures

Figure 1
Figure 1
Box plots depicting daily fluid intake and fluid balance within 72 h
Figure 2
Figure 2
Kaplan–Meier survival curve for 24-h fluid intake quartiles
Figure 3
Figure 3
Kaplan–Meier survival curve for mean fluid balance quartiles within 72 h
See this image and copyright information in PMC

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