Low fluid intake volume during the first 24 h and persistent negative fluid balance from the second day are associated with favorable prognosis for patients with sepsis.
Low fluid intake volume during the first 24 h and persistent negative fluid balance from the second day are associated with favorable prognosis for patients with sepsis.
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DOI：
10.3892/etm.2021.9818
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发表时间：
2021-04
影响因子：
2.7
通讯作者：
Chen EZ
中科院分区：
文献类型：
--
作者：
Wang YM;Chen Y;Zheng YJ;Huang YC;Chen WW;Ji R;Xu LL;Yang ZT;Sheng HQ;Qu HP;Mao EQ;Chen EZ
对于脓毒症和感染性休克的患者，何时限制液体摄入并实现液体负平衡仍然存在争议。本研究旨在评价最初24小时的液体摄入量和7天的液体平衡对脓毒症或感染性休克预后的影响。本研究对上海瑞金医院(中国)收治的337例脓毒症或感染性休克患者进行了回顾性研究。24 h内液体摄入量低的患者(液体摄入量为28.1±10.6ml/kg)的住院病死率(18.0%比27.3%，P=0.043)和机械通气量较短[0(0~6)比3(0~11)，P=0.025]明显低于高液体摄入量组(62.6±17.6ml/kg)。此外，从第二天(48小时)开始，幸存者每天的液体净平衡为负，而死亡患者的每日净液体平衡为正，持续7天，其中幸存者的液体平衡量明显低于死亡患者。最后，应用二元Logistic回归分析确定平均每日液体平衡(P<；0.001)和急性生理和慢性健康评估II评分(P=0.048)是否是脓毒症或感染性休克患者的独立预后因素。研究表明，头24小时的低液体摄入量和从第二天开始持续的液体负平衡与良好的预后相关。平均每日液体平衡是脓毒症或感染性休克患者的独立预后因素。
For patients with sepsis and septic shock, it remains controversial when to restrict fluid intake and achieve a negative fluid balance. The present study aimed to evaluate the effects of the fluid intake volume during the first 24 h as well as fluid balance for 7 days on the prognosis of sepsis or septic shock. A total of 337 patients diagnosed with sepsis or septic shock at Ruijin Hospital (Shanghai, China) were enrolled in the present retrospective study. Patients with a low fluid intake volume during the first 24 h (fluid intake, 28.1±10.6 ml/kg) had lower in-hospital mortality rates (18.0 vs. 27.3%, P=0.043) and a shorter duration of mechanical ventilation [0 (0-6) vs. 3 (0-11), P=0.025] than the high-fluid volume intake group (62.6±17.6 ml/kg). Furthermore, survivors exhibited a daily negative net fluid balance from the second day (48 h), whereas non-survivors had a daily positive net fluid balance for 7 days, where fluid balance volumes were significantly lower in survivors compared with those in non-survivors. Finally, binary logistic regression analysis was used to determine whether the mean daily fluid balance (P<0.001) and the Acute Physiologic and Chronic Health Evaluation II score (P=0.048) were independent prognostic factors for patients with sepsis or septic shock. It was indicated that a low fluid intake volume during the first 24 h and a persistent negative fluid balance from the second day were associated with favorable outcomes. The mean daily fluid balance was an independent prognostic factor or patients with sepsis or septic shock.
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影响因子：
9.8
作者：
Hoste EA;Maitland K;Brudney CS;Mehta R;Vincent JL;Yates D;Kellum JA;Mythen MG;Shaw AD;ADQI XII Investigators Group
通讯作者：
ADQI XII Investigators Group
影响因子：
4.6
作者：
Shen, Yanfei;Ru, Weizhe;Zhang, Weimin
通讯作者：
Zhang, Weimin
DOI：
10.1186/s13054-015-0970-1
发表时间：
2015-06-15
期刊：
Critical care (London, England)
影响因子：
--
作者：
Acheampong A;Vincent JL
通讯作者：
Vincent JL
影响因子：
158.5
作者：
Rivers, E;Nguyen, B;Tomlanovich, M
通讯作者：
Tomlanovich, M
影响因子：
8.8
作者：
Levy, Mitchell M.;Dellinger, R. Phillip;Angus, Derek C.
通讯作者：
Angus, Derek C.