Higher Fluid Balance Increases the Risk of Death From Sepsis: Results From a Large International Audit

6533b83afe1ef96bd12a71b9

RESEARCH PRODUCT

Higher Fluid Balance Increases the Risk of Death From Sepsis: Results From a Large International Audit

Sakr Y.Rubatto Birri P. N.Kotfis K.Nanchal R.Shah B.Kluge S.Schroeder M. E.Marshall J. C.Vincent J. -L E Tomas E Amisi Bibonge B Charra M Faroudy L Doedens Z Farina D Adler C Balkema A Kok S Alaya H Gharsallah D Muzha A Temelkov G Georgiev G Simeonov G Tsaryanski S Georgiev A Seliman S Vrankovic Z Vucicevic I Gornik B Barsic I Husedzinovic P Pavlik J Manak E Kieslichova R Turek M Fischer R Valkova L Dadak P Dostal J Malaska R Hajek A ŽIdková P Lavicka J Starkopf Z Kheladze M Chkhaidze V Kaloiani L Medve A Sarkany I Kremer Z Marjanek P Tamasi I Krupnova I Vanags V Liguts V Pilvinis S Vosylius G Kekstas M Balciunas J Kolbusz A Kübler B Mielczarek M Mikaszewska-sokolewicz K Kotfis B Tamowicz W Sulkowski P Smuszkiewicz A Pihowicz E Trejnowska N Hagau D Filipescu G Droc M Lupu A Nica R Stoica D Tomescu D Constantinescu G Valcoreanu Zbaganu A Slavcovici V Bagin D Belsky S Palyutin S Shlyapnikov D Bikkulova A Gritsan G Natalia E Makarenko V Kokhno A Tolkach E Kokarev B Belotserkovskiy K Zolotukhin V Kulabukhov L Soskic I Palibrk R Jankovic B Jovanovic M Pandurovic V Bumbasirevic B Uljarevic M Surbatovic N Ladjevic G Slobodianiuk V Sobona A Cikova A Gebhardtova C Jun S Yunbo J Dong S Feng M Duan Y Xu X Xue T Gao X Xing X Zhao C Li G Gengxihua H Tan J Xu L Jiang Q Tiehe Q Bingyu Q Shi Z Lv L Zhang L Jingtao Z Zhen Z Wang T Wang L Yuhong Q Zhai Y Chen C Wang W Jiang W Ruilan Y Chenv H Xiaobo H Ge T Yan C Yuhui J Zhang F Jian-hong H Zhu F Huo Y Wang C Li M Zhuang Z Ma J Sun L Liuqingyue M Yang J Meng S Ma Y Kang L Yu Q Peng Y Wei W Zhang R Sun A Yeung W Wan K Sin K Lee M Wijanti U Widodo H Samsirun T Sugiman C Wisudarti T Maskoen N Hata Y Kobe O Nishida D Miyazaki S Nunomiya S Uchino N Kitamura K Yamashita S Hashimoto H Fukushima N Nik Adib L Tai B Tony R Bigornia R Bigornia R Bigornia J Palo S Chatterjee B Tan A Kong S Goh C Lee C Pothirat B Khwannimit P Theerawit P Pornsuriyasak A Piriyapatsom A Mukhtar A Nabil Hamdy H Hosny A Ashraf M Mokhtari S Nowruzinia A Lotfi F Zand R Nikandish O Moradi Moghaddam J Cohen O Sold T Sfeir A Hasan D Abugaber H Ahmad T Tantawy S Baharoom H Algethamy A Amr G Almekhlafi R Coskun M Sungur A Cosar B Güçyetmez O Demirkiran E Senturk H Ulusoy H Atalan S Serin I Kati Z Alnassrawi A Almemari K Krishnareddy S Kashef A Alsabbah G Poirier J Marshall M Herridge M Herridge R Fernandez-medero G Fulda S Banschbach J Quintero E Schroeder C Sicoutris R Gueret R Kashyap P Bauer R Nanchal R Wunderink E Jimenez A Ryan D Prince J Edington F Van Haren A Bersten D J Hawkins M Kilminster D Sturgess M Ziegenfuss S O' Connor J Lipman L Campbell R Mcallister B Roberts P Williams R Parke P Seigne R Freebairn D Nistor C Oxley P Young R Valentini N Wainsztein P Comignani M Casaretto G Sutton P Villegas C Galletti J Neira D Rovira J Hidalgo F Sandi E Caser M Thompson M D'agostino Dias L Fontes M Lunardi N Youssef S Lobo R Silva J Sales Jr L Madeira Campos Melo M Oliveira M Fonte C Grion C Feijo V Rezende M Assuncao A Neves P Gusman D Dalcomune C Teixeira K Kaefer I Maia V Souza Dantas R Costa Filho F Amorim M Assef P Schiavetto J Houly F Bianchi F Dias C Avila J Gomez L Rego P Castro J Passos C Mendes C Grion G Colozza Mecatti M Ferrreira V Irineu M Guerreiro S Ugarte V Tomicic C Godoy W Samaniego I Escamilla L Castro Castro G Libreros Duque D Diaz-guio F Benítez A Guerra Urrego R Buitrago G Ortiz M Villalba Gaviria D Salas J Ramirez-arce E Salgado D Morocho J Vergara M Chung Sang C Orellana-jimenez L Garrido O Diaz D Resiere C Osorio A De La Vega R Carrillo V Sanchez A Villagomez R Martinez Zubieta M Sandia M Zalatiel M Poblano D Rodriguez Gonzalez F Arrazola L Juan Francisco S A ÑAmendys-silva M Hernandez D Rodriguez Cadena I Lopez Islas C Ballesteros Zarzavilla A Matos I Oyanguren J Cerna R Quispe Sierra R Jimenez L Castillo R Ocal A Sencan S Mareque Gianoni A Deicas J Hurtado G Burghi A Martinelli I Von Der Osten C Du Maine M Bhattacharyya S Bandyopadhyay S Yanamala P Gopal S Sahu M Ibrahim D Rathod N Mukundan A Dewan P Amin S Samavedam B Shah D Gurupal B Lahkar A Mandal M Sircar S Ghosh V Balasubramani F Kapadia S Vadi K Nair S Tripathy S Nandakumar J Sharma A Kar S Jha K Zirpe-gurav M Patel A Bhavsar D Samaddar A Kulkarni M Hashmi W Ali S Nadeem K Indraratna A Margarit P Urbanek J Schlieber J Reisinger J Auer A Hartjes A Lerche T Janous E Kink W Krahulec K Smolle M Van Der Schueren P Thibo M Vanhoof I Ahmet G Philippe P Dufaye O Jacobs V Fraipont P Biston A Dive Y Bouckaert E Gilbert B Gressens E Pinck V Collin J L Vincent J De Waele R Rimachi D Gusu K De Decker K Mandianga L Heytens X Wittebole S Herbert V Olivier W Vandenheede P Rogiers P Kolodzeike M Kruse T Andersen V Harjola K Saarinen M Leone A Durocher S Moulront A Lepape M Losser P Cabaret E Kalaitzis E Zogheib P Charve B Francois J Y Lefrant B Beilouny X Forceville B Misset F Jacobs F Bernard D Payen A Wynckel V Castelain A Faure P Lavagne L Thierry M Moussa A Vieillard-baron M Durand M Gainnier C Ichai S Arens C Hoffmann M Kaffarnik C Scharnofske I Voigt C Peckelsen M Weber J Gille A Lange G Schoser A Sablotzki U Jaschinski A Bluethgen F Vogel A Tscheu T Fuchs M Wattenberg T Helmes S Scieszka M Heintz S Sakka J Kohler F Fiedler M Danz Y Sakr R Riessen T Kerz A Kersten F Tacke G Marx T Volkert A Schmutz A Nierhaus S Kluge P Abel R Janosi S Utzolino H Bracht S Toussaint M Giannakou Peftoulidou P Myrianthefs A Armaganidis C Routsi A Xini E Mouloudi I Kokoris G Kyriazopoulos S Vlachos A Lavrentieva P Partala G Nakos A Moller S Stefansson J Barry R O'leary C Motherway M Faheem E Dunne M Donnelly T Konrad E Bonora C Achilli S Rossi G Castiglione A Peris D Albanese N Stocchetti G Citerio L Mozzoni E Sisillo P De Negri M Savioli P Vecchiarelli F Puflea V Stankovic G Minoja S Montibeller P Calligaro R Sorrentino M Feri M Zambon E Colombaroli A Giarratano T Pellis C Capra M Antonelli A Gullo C Chelazzi A De Capraris N Patroniti M Girardis F Franchi G Berlot M Buttigieg H Ponssen J Ten Cate L Bormans S Husada M Buise B Van Der Hoven A Reidinga M Kuiper P Pickkers G Kluge S Den Boer J Kesecioglu H Van Leeuwen H Flaatten S Mo V Branco F Rua E Lafuente M Sousa N Catorze M Barros L Pereira A Vintém De Oliveira J Gomes I Gaspar M Pereira M Cymbron A Dias E Almeida S Beirao I Serra R Ribeiro P Povoa F Faria Z Costa-e-silva J Nóbrega F Fernandes J Gabriel G Voga E Rupnik L Kosec M Kerin Povšic I Osojnik V Tomic A Sinkovic J González E Zavala J Pérez Valenzuela L Marina P Vidal-cortés P Posada A Ignacio Martin-loeches N Muñoz Guillén M Palomar J Sole-violan A Torres M Gonzalez Gallego G Aguilar R Montoiro Alluév M Argüeso M Parejo M Palomo Navarro A Jose N Nin F Alvarez Lerma O Martinez E Tenza Lozano S Arenal López M Perez Granda S Moreno C Llubia C De La Fuente Martos P Gonzalez-arenas N Llamas Fernández B Gil Rueda I Estruch Pons N Cruza F Maroto A Estella A Ferrer L Iglesias Fraile B Quindos A Quintano M Tebar P Cardinal A Reyes A Rodríguez A Abella S García Del Valle S Yus E Maseda J Berezo A Tejero Pedregosa C Laplaza R Ferrer J Rico-feijoo M Rodríguez P Monedero K Eriksson D Lind D Chabanel H Zender K Heer B Frankenberger S Jakob A Haller S Mathew R Downes C Barrera Groba A Johnston R Meacher R Keays P Haji-michael C Tyler A Ferguson S Jones D Tyl A Ball J Vogel M Booth P Downie M Watters S Brett M Garfield L Everett S Heenen S Dhir Z Beardow M Mostert S Brosnan N Pinto S Harris A Summors N Andrew A Rose R Appelboam O Davies E Vickers B Agarwal T Szakmany S Wimbush I Welters R Pearse R Hollands J Kirk-bayley N Fletcher B Bray D Brealey

subject

Internationality Time Factors Databases Factual medicine.medical_treatment lnfectious Diseases and Global Health Radboud Institute for Molecular Life Sciences [Radboudumc 4]Settore MED/41 - Anestesiologia Critical Care and Intensive Care Medicine law.invention 0302 clinical medicine law Risk Factors 80 and over 030212 general & internal medicine Hospital Mortality 610 Medicine & health Aged 80 and over Medical Audit fluid output Middle Aged Water-Electrolyte Balance fluid administration Intensive care unit fluid administration; fluid output; outcome; septic shock; Adult; Aged; Aged 80 and over; Databases Factual; Hospital Mortality; Humans; Intensive Care Units; Internationality; Medical Audit; Middle Aged; Risk Factors; Sepsis; Time Factors; Fluid Therapy; Water-Electrolyte Balance; Critical Care and Intensive Care Medicine Intensive Care Units Cohort outcome Human Cohort study Adult medicine.medical_specialty Time Factor Sepsi Intensive Care Unit Observational Study Sepsis 03 medical and health sciences Databases Sepsis Hemofiltration medicine Journal Article Humans Risk factor Intensive care medicine Factual Hetastarch Aged business.industry Septic shock Risk Factor 030208 emergency & critical care medicine fluid administration fluid output outcome septic shock medicine.disease septic shock Fluid Therapy business

description

Contains fulltext : 177598.pdf (Publisher’s version ) (Closed access) OBJECTIVES: Excessive fluid therapy in patients with sepsis may be associated with risks that outweigh any benefit. We investigated the possible influence of early fluid balance on outcome in a large international database of ICU patients with sepsis. DESIGN: Observational cohort study. SETTING: Seven hundred and thirty ICUs in 84 countries. PATIENTS: All adult patients admitted between May 8 and May 18, 2012, except admissions for routine postoperative surveillance. For this analysis, we included only the 1,808 patients with an admission diagnosis of sepsis. Patients were stratified according to quartiles of cumulative fluid balance 24 hours and 3 days after ICU admission. MEASUREMENTS AND MAIN RESULTS: ICU and hospital mortality rates were 27.6% and 37.3%, respectively. The cumulative fluid balance increased from 1,217 mL (-90 to 2,783 mL) in the first 24 hours after ICU admission to 1,794 mL (-951 to 5,108 mL) on day 3 and decreased thereafter. The cumulative fluid intake was similar in survivors and nonsurvivors, but fluid balance was less positive in survivors because of higher fluid output in these patients. Fluid balances became negative after the third ICU day in survivors but remained positive in nonsurvivors. After adjustment for possible confounders in multivariable analysis, the 24-hour cumulative fluid balance was not associated with an increased hazard of 28-day in-hospital death. However, there was a stepwise increase in the hazard of death with higher quartiles of 3-day cumulative fluid balance in the whole population and after stratification according to the presence of septic shock. CONCLUSIONS: In this large cohort of patients with sepsis, higher cumulative fluid balance at day 3 but not in the first 24 hours after ICU admission was independently associated with an increase in the hazard of death.

year	journal	country	edition	language
2017-03-01

10.1097/ccm.0000000000002189 https://doi.org/10.1097/CCM.0000000000002189