Impact of a cumulative positive fluid balance during the first three ICU days in patients with sepsis: a propensity score-matched cohort study

Background The optimal strategy for fluid management during the first few days of ICU in sepsis patients remains controversial. We aimed to investigate the impact of cumulative fluid balance during the first three days of ICU on the mortality of patients with sepsis. Methods This study analyzed pros...

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Bibliographic Details
Published in:Annals of intensive care 2023-10, Vol.13 (1), p.105-105, Article 105
Main Authors: Hyun, Dong-gon, Ahn, Jee Hwan, Huh, Jin Won, Hong, Sang-Bum, Koh, Younsuck, Oh, Dong Kyu, Lee, Su Yeon, Park, Mi Hyeon, Lee, Haein, Lim, Chae-Man
Format: Article
Language:English
Subjects:
Anesthesiology
Cohort analysis
Critical Care Medicine
Emergency Medicine
Fluid therapy
Hemodynamics
Intensive
Intensive care
Intravenous therapy
Medicine
Medicine & Public Health
Mortality
Resuscitation
Sepsis
Septic shock
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Summary:Background The optimal strategy for fluid management during the first few days of ICU in sepsis patients remains controversial. We aimed to investigate the impact of cumulative fluid balance during the first three days of ICU on the mortality of patients with sepsis. Methods This study analyzed prospectively collected data from the Korean Sepsis Alliance Database, which registered 11,981 sepsis patients from 20 hospitals. We selected three propensity score-matched cohorts consisting of patients with a negative or positive cumulative fluid balance during the first three ICU days: from ICU admission to the first midnight as the D1 cohort, until the second midnight as the D2 cohort, and until the third midnight as the D3 cohort. The propensity score for fluid balance was calculated using covariates including the amount of fluid output during the first three ICU days. The primary outcome was mortality at day 28 in the ICU. Results From a total of 11,981 patients, 2516 patients were included for propensity score matching. After matching in a 1:1 ratio, there were 483, 373, and 392 matched pairs of patients assigned to the D1, D2, and D3 cohorts, respectively. In the D1 cohort, there were no significant differences in mortality at day 28 (hazard ratio [HR], 1.17; 95% confidence interval [CI] 0.85–1.60; P  = 0.354) between the two groups. The positive fluid groups in both the D2 (HR, 2.13; 95% CI 1.48–3.06; P  
ISSN:2110-5820
2110-5820
DOI:10.1186/s13613-023-01178-x