The effect of fluid balance on outcomes in patients with sepsis; experience of a tertiary hospital

• Published in: Pamukkale Medical Journal 2022, Vol.15 (1), p.87-94
• Main Authors: Uysal Dönmez,Deniz, Dirol,Hülya, Erdoğan,Abdullah
• Format: Article
• Language: English
• Subjects: Blood gas analysis; Length of stay; Mortality; Sağlık Hizmetleri; Sepsis; Tıp; Ventilation; Ventilators
• ISSN: 1309-9833; 1308-0865
• DOI: 10.31362/patd.938235

Purpose: Fluid replacement is vital for stabilizing hemodynamic status in sepsis. However, the positive fluid balance may result in pulmonary edema and may be associated with increased mortality. Materials and methods: This is a single-center, retrospective study in which the patients, supported with mechanical ventilation (MV) due to sepsis, were enrolled. All the data about the demographic features, medications, MV duration, vital signs, blood gas analysis, blood tests, the fluid balance were obtained from the patient files and nursing reports. Patients were subclassed positive, negative and balanced according to fluid balance and compared to each other. Results: A total of fifty patients with sepsis were included in the study. Twenty-six (52%) of the patients were male and the mean age was 66.58±3.25 years. The mortality rate was 90%. The mean fluid intake and output were 3481.8±1002.7, 1877.6±921.3 milliliters, respectively. Forty-two (84%) were in positive fluid balance, 6 (12%) in negative fluid balance, and 2 (4%) in balance. There was no significant difference between the fluid balance subgroups in terms of length of stay in the ICU, duration of mechanical ventilation, and mortality. The use of diuretics was significantly higher in patients with positive fluid balance (p=0.023). CRP was significantly higher while serum albumin was lower in patients with positive fluid balance (respectively, p=0.003, p=0.034). There was no difference between the mean GCS, SOFA scores of survivors and nonsurvivors but the mean APACHE II scores in nonsurvivors were significantly higher than in survivors (p=0.026). Conclusion: Our study showed that positive fluid balance did not affect the length of stay in the ICU, duration of mechanical ventilation and mortality, and that APACHE II was better than SOFA and GCS in predicting mortality.