Clinical Outcomes Associated with Fluid Overload in Critically Ill Pediatric Patients.
BACKGROUND
Fluid overload (FO) has been accused as being one of the ICU problems affecting morbidity and mortality. The aim of the study was to assess the effect and critical threshold of FO that is related to mortality.


METHODS
This prospective observational study was conducted in a pediatric ICU. All patients admitted (n = 203) during 12 months with a length of stay more than 48 h were recruited.


RESULTS
FO was found to be related to mortality (p = 0.025) but was not proved to be an independent risk factor of fatal outcome by the logistic regression model. This raises the suspicion about any cause-effect relationship between FO and mortality. Even though, FO was statistically a fair discriminator of death (AUC = 0.655, p = 0.0008) and a cutoff level of FO was set at 7%. Kaplan-Meier curve showed that cumulative of survival differed significantly between groups of patients with FO more and less than 7% (p = 0.002).


CONCLUSION
Frequent and accurate monitoring of FO is crucial among critically ill patients. The present study suggested a threshold of 7% FO beyond which a more conservative regimen of fluid administration might improve patients' outcome.
['El-Nawawy|Ahmed|A|', 'Moustafa|Azza A|AA|', 'Antonios|Manal A M|MAM|', 'Atta|May M|MM|']
D058186:Acute Kidney Injury D002648:Child D002675:Child, Preschool D016638:Critical Illness D005260:Female D005440:Fluid Therapy D006801:Humans D007223:Infant D007226:Infant Mortality D007231:Infant, Newborn D015278:Intensive Care Units, Pediatric D053208:Kaplan-Meier Estimate D007902:Length of Stay D008297:Male D011446:Prospective Studies D012307:Risk Factors D015996:Survival Rate D016896:Treatment Outcome D014883:Water-Electrolyte Imbalance
fluid overload morbidity mortality intravenous fluid threshold of fluid overload