RESUMO
Objectives: To study the association of fluid overload withmortality and morbidity in critically-ill mechanically ventilatedchildren.Design: Prospective observational study.Setting: Pediatric Intensive Care Unit (PICU) of a tertiary carehospital, New Delhi, India.Participants: 118 children (age 1 mo - 15 y) requiring mechanicalventilation.Outcome measures: Primary: Association of fluid overload withmortality. Secondary: Association of fluid overload withoxygenation, organ dysfunction, duration of mechanicalventilation and PICU stay.Results: Cumulative fluid overload of ?15% was observed in 74(62.7%) children. About 50% of these children reachedcumulative fluid overload of ?15% within the first 5 days of PICUstay. The mortality was 40.5% in those with ?15% cumulative fluidcompared to 34% in the rest [OR (95% CI): 1.02 (0.97, 1.07)]. Onmultivariate analysis, after adjusting for confounders, cumulativefluid overload ?15% was associated with higher maximumPELOD (pediatric logistic organ dysfunction) score (Median: 21vs. 12; P = 0.03), longer median duration of mechanicalventilation (10 vs. 4 d; P <0.0001) and PICU stay (13.5 vs. 6 d; P<0.0001). There was no significant association of fluid overloadwith oxygenation index (P=0.32).Conclusion: There is no association of fluid overload withmortality. However, it is associated with poor organ function,longer duration of mechanical ventilation and PICU stay incritically-ill, mechanically ventilated children.