Fluid overload: clinical outcomes in pediatric intensive care unit.

Autores da FMUP

• Luís Filipe Ribeiro De Azevedo

  Autor

Participantes de fora da FMUP

• Gomes RADS
• Simões BPC
• Detomi LS
• Rodrigues KES
• Rodrigues AT
• Melo MDCB
• Fonseca JGD

Unidades de investigação

• Laboratório Associado RISE- Rede de Investigação em Saúde

  

  Investigador

  Fernando Carlos De Landér Schmitt

• Medicina da Comunidade, Informação e Decisão em Saúde

• RISE-Health

  

  Investigador

  Fernando Carlos De Landér Schmitt

Abstract

OBJECTIVE: The aim of this study was to analyze the effects of fluid overload related to mechanical ventilation, renal replacement therapy, and evolution to discharge or death in critically ill children. METHODS: A retrospective study in a Pediatric Intensive Care Unit for two years. Patients who required invasive ventilatory support and vasopressor and/or inotropic medications were considered critically ill. RESULTS: 70 patients were included. The mean age was 6.8 ± 6 years. There was a tolerable increase in fluid overload during hospitalization, with a median of 2.45% on the first day, 5.10% on the third day, and 8.39% on the tenth day. The median fluid overload on the third day among those patients in pressure support ventilation mode was 4.80% while the median of those who remained on controlled ventilation was 8.45% (p?=?0.039). Statistical significance was observed in the correlations between fluid overload measurements on the first, third, and tenth days of hospitalization and the beginning of renal replacement therapy (p?=?0.049) and between renal replacement therapy and death (p?=?0.01). The median fluid overload was 7.50% in patients who died versus 4.90% in those who did not die on the third day of hospitalization (p?=?0.064). There was no statistically significant association between death and the variables sex or age. CONCLUSIONS: The fluid overload on the third day of hospitalization proved to be a determinant for the clinical outcomes of weaning from mechanical ventilation, initiation of renal replacement therapy, discharge from the intensive care unit, or death among these children.

Copyright © 2022. Published by Elsevier Editora Ltda.

Keywords

• Children; Critically ill; Fluid overload