A positive fluid balance is an independent prognostic factor in patients with sepsis.
A positive fluid balance is an independent prognostic factor in patients with sepsis.
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DOI：
10.1186/s13054-015-0970-1
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发表时间：
2015-06-15
期刊：
影响因子：
--
通讯作者：
Vincent JL
中科院分区：
文献类型：
--
作者：
Acheampong A;Vincent JL
静脉输液是脓毒症治疗的重要组成部分，但体液平衡阳性与预后较差有关。我们分析了脓毒症患者体液平衡阳性及其持续时间是否是一个独立的预后因素。我们前瞻性地研究了173名在重症监护室连续接受脓毒症治疗的成人患者7天的液体摄入和排出情况。173例患者中，59例死亡（34%）。非幸存者的平均每日液体摄入量高于幸存者（59±24 ml/kg vs 48±23 ml/kg, p = 0.03），但输出量相似。结果，非幸存者的每日体液平衡是幸存者的两倍多（29±22 vs 13±19 ml/kg, p <0.001）。长期保持体液正平衡与死亡率增加有关。使用多变量时间相关Cox模型，体液平衡阳性与较高的死亡率独立相关（校正风险比为1.014 [1.007-1.022]/ ml/kg增加，p <0.001）。长期维持每日体液平衡阳性与脓毒症患者较高的死亡率密切相关。本文的在线版本（doi:10.1186/s13054-015-0970-1）包含补充材料，可供授权用户使用。
Intravenous fluid administration is an essential component of sepsis management, but a positive fluid balance has been associated with worse prognosis. We analyzed whether a positive fluid balance and its persistence over time was an independent prognostic factor in septic patients. We prospectively studied fluid intake and output for 7 days in 173 consecutive adult patients treated for sepsis in our Department of Intensive Care. Of the 173 patients, 59 died (34 %). Mean daily fluid intake was higher in non-survivors than in survivors (59 ± 24 ml/kg vs. 48 ± 23 ml/kg, p = 0.03), but output volumes were similar. As a result, the daily fluid balance was more than twice as large in the non-survivors as in the survivors (29 ± 22 vs. 13 ± 19 ml/kg, p <0.001). Persistence of a positive fluid balance over time was associated with increased mortality. Using a multivariable time-dependent Cox model, a positive fluid balance was independently associated with higher mortality (adjusted hazard ratio 1.014 [1.007–1.022] per ml/kg increase, p <0.001). Persistence of a positive daily fluid balance over time was quite strongly associated with a higher mortality rate in septic patients. The online version of this article (doi:10.1186/s13054-015-0970-1) contains supplementary material, which is available to authorized users.
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影响因子：
8.8
作者：
Vincent, JL;Sakr, Y;Payen, D
通讯作者：
Payen, D
DOI：
10.1016/s0140-6736(12)61815-7
发表时间：
2013-03-02
期刊：
Lancet (London, England)
影响因子：
--
作者：
Vincent JL;Opal SM;Marshall JC;Tracey KJ
通讯作者：
Tracey KJ
DOI：
10.1186/cc13072
发表时间：
2013-10-20
期刊：
Critical care (London, England)
影响因子：
--
作者：
Micek ST;McEvoy C;McKenzie M;Hampton N;Doherty JA;Kollef MH
通讯作者：
Kollef MH
影响因子：
9.6
作者：
Murphy, Claire V.;Schramm, Garrett E.;Kollef, Marin H.
通讯作者：
Kollef, Marin H.
影响因子：
3.6
作者：
Sirvent, Josep-Maria;Ferri, Cristina;Lorencio, Carolina
通讯作者：
Lorencio, Carolina