Relationship between fluid overload and mortality and morbidity in pediatric intensive care unit.

ABSTRACT

OBJECTIVE: The relationship between fluid overload and clinical outcomes was investigated. DESIGN: This study is an observational and analytic study of a retrospective cohort. SETTINGS Pediatric intensive care units. PATIENTS OR PARTICIPANTS: Between 2019 and 2021 children who needed intensive care were included in the study. INTERVENTIONS: No intervention. MAIN VARIABLE OF INTEREST Early, peak and cumulative fluid overload were evaluated. RESULTS: The mortality rate was 11.7% (68/513). When fluid overloads were examined in terms of mortality, the percentage of early fluid overload was 1.86 and 3.35, the percent of peak fluid overload was 2.87 and 5.54, and the percent of cumulative fluid overload was 3.40 and 8.16, respectively, in the survivor and the non-survivor groups. After adjustment for age, severity of illness, and other potential confounders, peak (aOR = 1.15; 95%CI 1.05-1.26; p 0.002) and cumulative (aOR = 1.10; 95%CI 1.04-1.16; p < 0.001) fluid overloads were determined as independent risk factors associated with mortality. When the cumulative fluid overload is 10% or more, a 3.9-fold increase mortality rate was calculated. It is found that the peak and cumulative fluid overload, had significant negative correlation with intensive care unit free days and ventilator free days. CONCLUSIONS: It is found that peak and cumulative fluid overload in critically ill children were independently associated with intensive care unit mortality and morbidity.