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Critical Care
Published in: Critical Care 1/2015

Open Access 01-12-2015 | Research

A positive fluid balance is an independent prognostic factor in patients with sepsis

Authors: Angela Acheampong, Jean-Louis Vincent

Published in: Critical Care | Issue 1/2015

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Abstract

Introduction

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.

Methods

We prospectively studied fluid intake and output for 7 days in 173 consecutive adult patients treated for sepsis in our Department of Intensive Care.

Results

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).

Conclusions

Persistence of a positive daily fluid balance over time was quite strongly associated with a higher mortality rate in septic patients.
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Metadata
Title
A positive fluid balance is an independent prognostic factor in patients with sepsis
Authors
Angela Acheampong
Jean-Louis Vincent
Publication date
01-12-2015
Publisher
BioMed Central
Published in
Critical Care / Issue 1/2015
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/s13054-015-0970-1

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