Assessment of prescribed vs. achieved fluid balance during continuous renal replacement therapy and mortality outcome

Fluid management during continuous renal replacement therapy (CRRT) requires accuracy in the prescription of desired patient fluid balance (FBGoal) and precision in the attainable patient fluid balance (FBAchieved). Herein, we examined the association of the gap between prescribed vs. achieved patie...

Full description

Saved in:
Bibliographic Details
Published in:PloS one 2022-08, Vol.17 (8), p.e0272913
Main Authors: Neyra, Javier A, Lambert, Joshua, Ortiz-Soriano, Victor, Cleland, Daniel, Colquitt, Jon, Adams, Paul, Bissell, Brittany D, Chan, Lili, Nadkarni, Girish N, Tolwani, Ashita, Goldstein, Stuart L
Format: Article
Language:English
Subjects:
Acute Kidney Injury - therapy
Acute renal failure
Adult
Adults
Biology and Life Sciences
Care and treatment
Cohort Studies
Computer and Information Sciences
Continuous Renal Replacement Therapy
Critical Illness - therapy
Death
Electronic health records
Extracorporeal membrane oxygenation
Female
Fluid management
Health risks
Humans
Illnesses
Male
Medicine and Health Sciences
Middle Aged
Mortality
Observational studies
Parameters
Patient outcomes
Patients
Renal Replacement Therapy
Research and Analysis Methods
Retrospective Studies
Survival
Ultrafiltration
Ventilators
Water-Electrolyte Balance
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Fluid management during continuous renal replacement therapy (CRRT) requires accuracy in the prescription of desired patient fluid balance (FBGoal) and precision in the attainable patient fluid balance (FBAchieved). Herein, we examined the association of the gap between prescribed vs. achieved patient fluid balance during CRRT (%FBGap) with hospital mortality in critically ill patients. Cohort study of critically ill adults with acute kidney injury (AKI) requiring CRRT and a prescription of negative fluid balance (mean patient fluid balance goal of negative ≥0.5 liters per day). Fluid management parameters included: 1) NUF (net ultrafiltration rate); 2) FBGoal; 3) FBAchieved; and 4) FBGap (% gap of fluid balance achieved vs. goal), all adjusted by patient's weight (kg) and duration of CRRT (hours). Data from 653 patients (median of 102.2 patient-hours of CRRT) were analyzed. Mean (SD) age was 56.7 (14.6) years and 61.9% were male. Hospital mortality rate was 64%. Despite FBGoal was similar in patients who died vs. survived, survivors achieved greater negative fluid balance during CRRT than non-survivors: median FBAchieved -0.25 [-0.52 to -0.05] vs. 0.06 [-0.26 to 0.62] ml/kg/h, p
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0272913