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Fluid Overload and Risk of Mortality in Critically Ill Patients.

PMID: 31593067 (view PubMed database entry)
DOI: 10.1097/dcc.0000000000000383 (read at publisher's website )

Jessica Gomes, Marcele Liliane Pesavento, Flavia Fernandes Manfredi de Freitas, Filipe Utuari de Andrade Coelho,

BACKGROUND:Fluid overload (FO) is a condition present in critical care units, and it is associated with clinical complications and worse outcomes for severe patients. OBJECTIVE:The aim of this study was to verify if FO is a risk factor for mortality in critically ill patients. METHODS:Retrospective study performed in a Brazilian intensive care unit, from January to March 2016, with patients older than 18 years and hospitalized for more than 24 hours. Demographic and clinical data, as well as fluid balance and overload, were analyzed to verify the risk factors for mortality. A logistic regression model was elaborated, and significance was set at P < .05. RESULTS:There were 158 patients included, of which only 13 (8.2%) presented FO. Mortality was verified in individuals 30 (18.9%), of whom only 7 (23.3%) developed FO, which was lower in survivors 6 (4.9%), P = .001. In the simple regression model, the FO was significant (odds ratio [OR], 6.23; 95% confidence interval [CI], 2.04-19.53), P = .001. However, in the multiple regression model, there were significant findings only for mechanical ventilation (OR, 5.86; 95% CI, 2.10-18.12, P = .001), acute kidney injury (OR, 4.05; 95% CI, 1.53-11; P = .001), and noradrenaline (OR, 3.85; 95% CI, 1.01-9.51; P = .041); FO was not significant (OR, 3.68; 95% CI, 0.91-15.55; P = .069). CONCLUSION:Fluid overload is higher in patients who died. Therefore, it was not considered a risk factor for mortality.

Dimens Crit Care Nurs (Dimensions of critical care nursing : DCCN)
[2019, 38(6):293-299]

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