scholarly journals Effect of fluid balance control in critically ill patients: Design of the stepped wedge trial POINCARE-2

2019 ◽  
Vol 83 ◽  
pp. 109-116
Author(s):  
Nelly Agrinier ◽  
Alexandra Monnier ◽  
Laurent Argaud ◽  
Michel Bemer ◽  
Jean-Marc Virion ◽  
...  
Keyword(s):  
Critically Ill ◽  
Fluid Balance ◽  
Critically Ill Patients ◽  
Balance Control ◽  
Stepped Wedge ◽  
Stepped Wedge Trial

scholarly journals Mid-regional pro-adrenomedullin (MR-proADM), a marker of positive fluid balance in critically ill patients: results of the ENVOL study

Critical Care ◽  
2016 ◽  
Vol 20 (1) ◽  
Author(s):  
Bernard Vigué ◽  
Pierre-Etienne Leblanc ◽  
Frédérique Moati ◽  
Eric Pussard ◽  
Hussam Foufa ◽  
...  
Keyword(s):  
Critically Ill ◽  
Fluid Balance ◽  
Critically Ill Patients ◽  
Positive Fluid Balance

scholarly journals Relation between fluid balance and incidence of morbidity and mortality rates in critically ill patients prospective observational study

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
M G A Gerges ◽  
H M M Elazzazi ◽  
M H S A Elsersi ◽  
S A R Mustafa ◽  
M A Saeed
Keyword(s):  
Mechanical Ventilation ◽  
Observational Study ◽  
Critically Ill ◽  
Fluid Balance ◽  
Critically Ill Patients ◽  
Prospective Observational Study ◽  
Mortality Rates ◽  
Morbidity And Mortality ◽  
University Hospitals ◽  
Cumulative Fluid Balance

Abstract Background While administration of fluid can be lifesaving, it has been suggested that the fluid accumulation after initial resuscitation and hemodynamic stabilization can contribute to potentially avoidable adverse effects and less favorable outcomes. Objective The aim of this study is to assess whether positive fluid balance in comparison with negative or even fluid balance is associated with increased morbidity and mortality rates in critically ill patients. Patients and Methods This prospective observational study was performed on 145 Patients older than 18 years admitted to intensive care units at Helwan university hospitals and Ain shams university hospitals during the period from November 2017 till May 2018. Results A total of 145 patients with an ICU mortality rate of 14.5% were enrolled. The median cumulative fluid balance of the 124 patients who survive was -110 ml (IQR -2.1-2.2 L) after the fourth day following randomization while the median cumulative fluid balance of the 21 patients who not survive was 3800 ml (IQR 1.7-5.2 L) after the fourth day in ICU. In our study critically ill patients with fluid balance more than 1.2 litres per day had higher ICU complications: increased risk of AKI, longer ICU and hospital stays, and mechanical ventilation, and fluid balance was independently associated with mortality. Conclusion In the view of this study, we concluded that:Zero fluid balance and negative fluid balance independently associated with decrease mortality and morbidity rates in critically ill patients after 4 days from admission in ICU.There was higher cumulative fluid balance in non survivors compared to survivors. Cumulative fluid balance after 4 days from admission was independently predictive of mortality in a heterogeneous group of critically ill patients.96 hour negative fluid balance in critically ill patients was associated with less length of stay at ICU and less mechanical ventilation duration.Positive fluid balance, mechanical ventilation, vasopressors, and high admission SAPS II, SOFA, APACHE II and KIDGO were significantly associated with high mortality.

scholarly journals Fluid balance as a biomarker: impact of fluid overload on outcome in critically ill patients with acute kidney injury

Critical Care ◽  
2008 ◽  
Vol 12 (4) ◽  
pp. 169 ◽  
Author(s):  
Sean M Bagshaw ◽  
Patrick D Brophy ◽  
Dinna Cruz ◽  
Claudio Ronco
Keyword(s):  
Acute Kidney Injury ◽  
Critically Ill ◽  
Fluid Balance ◽  
Critically Ill Patients ◽  
Fluid Overload ◽  
Kidney Injury

Value and determinants of the mean systemic filling pressure in critically ill patients

2015 ◽  
Vol 309 (5) ◽  
pp. H1003-H1007 ◽  
Author(s):  
Xavier Repessé ◽  
Cyril Charron ◽  
Julia Fink ◽  
Alain Beauchet ◽  
Florian Deleu ◽  
...  
Keyword(s):  
Critically Ill ◽  
Fluid Balance ◽  
Critically Ill Patients ◽  
Filling Pressure ◽  
Time Of Death ◽  
Large Variability ◽  
Mean Systemic Filling Pressure ◽  
Systemic Filling ◽  
A Prospective Study ◽  
Systemic Filling Pressure

Mean systemic filling pressure (Pmsf) is a major determinant of venous return. Its value is unknown in critically ill patients (ICU). Our objectives were to report Pmsf in critically ill patients and to look for its clinical determinants, if any. We performed a prospective study in 202 patients who died in the ICU with a central venous and/or arterial catheter. One minute after the heart stopped beating, intravascular pressures were recorded in the supine position after ventilator disconnection. Parameters at admission, during the ICU stay, and at the time of death were prospectively collected. One-minute Pmsf was 12.8 ± 5.6 mmHg. It did not differ according to gender, severity score, diagnosis at admission, fluid balance, need for and duration of mechanical ventilation, or length of stay. Nor was there any difference according to suspected cause of death, classified as shock (cardiogenic, septic, and hemorrhagic) and nonshock, although a large variability of values was observed. The presence of norepinephrine at the time of death (102 patients) was associated with a higher 1-min Pmsf (14 ± 6 vs. 11.4 ± 4.5 mmHg), whereas the decision to forgo life-sustaining therapy (34 patients) was associated with a lower 1-min Pmsf (10.9 ± 3.8 vs. 13.1 ± 5.3 mmHg). In a multiple-regression analysis, norepinephrine (β = 2.67, P = 0.0004) and age (β = −0.061, P = 0.022) were associated with 1-min Pmsf. One-minute Pmsf appeared highly variable without any difference according to the kind of shock and fluid balance, but was higher with norepinephrine.

scholarly journals Negative fluid balance 48 hours after admission improves survival at 28 days in critically ill patients

Critical Care ◽  
2012 ◽  
Vol 16 (S1) ◽  
Author(s):  
M Cuartero ◽  
AJ Betbese ◽  
K Nuñez ◽  
J Baldira ◽  
L Zapata
Keyword(s):  
Critically Ill ◽  
Fluid Balance ◽  
Critically Ill Patients ◽  
Negative Fluid Balance

The dose - response association between fluid overload and hospital mortality in critically ill patients: a multicenter, prospective, observational cohort study

2020 ◽  
Author(s):  
Meiping Wang ◽  
Bo Zhu ◽  
Li Jiang ◽  
Ying Wen ◽  
Bin Du ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Critically Ill ◽  
Dose Response ◽  
Fluid Balance ◽  
Critically Ill Patients ◽  
Fluid Overload ◽  
Fluid Management ◽  
Management Strategies ◽  
Icu Admission ◽  
Increased Risk

Abstract Background Fluid management is important for ensuring hemodynamic stability in critically ill patients but easily leads to fluid overload. However, the optimal fluid balance plot or range for critically ill patients is unknown. This study aimed to explore the dose-response relationship between fluid overload (FO) and hospital mortality in critically ill patients.Methods Data were derived from the China Critical Care Sepsis Trial (CCCST). Patients with sequential fluid data for the first 3 days of admission to the ICU were included. FO was expressed as the ratio of the cumulative fluid balance (L) and initial body weight (kg) at ICU admission as a percentage. Maximum fluid overload (MFO) was defined as the peak FO value during the first 3 days of ICU admission. We used logistic regression models with restricted cubic splines to assess the relationship between MFO and the risk of hospital mortality.ResultsIn total, 3850 patients were included, 929 (24.1%) of whom died in hospital. For each 1% L/kg increase in the FO, the risk of hospital mortality increased by 4% (HR 1.04, 95% CI 1.03 - 1.05, P < 0.001). FO greater than 10% was associated with a 44% increased HR of hospital mortality compared with FO less than 5% (HR 1.44, 95% CI 1.27 - 1.67). Notably, we also found a non-linear dose-response association between MFO and hospital mortality.Conclusions Both higher and lower fluid balance were associated with an increased risk of hospital mortality. Further studies should explore this relationship and seek for the optimal fluid management strategies for critically ill patients.

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