The impact of fluid balances in the first 48 hours on mortality in the critically ill patients

Introduction: There has been increasing evidence of detrimental effects of cumulative positive fluid balance in critically ill patients. The postulated mechanism of harm is the development of interstitial oedema, with resultant increase morbidity and mortality. We aim to assess the impact of positiv...

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Main Authors:	Md Ralib, Azrina, Hamzah, Norhalini, Nasir, Majdiah Syahirah, Mat Nor, Mohd Basri
Format:	Article
Language:	English English
Published:	International Islamic University Malaysia 2016
Subjects:	R Medicine (General)
Online Access:	http://irep.iium.edu.my/51171/ http://irep.iium.edu.my/51171/ http://irep.iium.edu.my/51171/1/51171_-_The_impact_of_fluid_balances_in_the_first_48_hours_on_mortality_in_the_critically_ill_patient.pdf http://irep.iium.edu.my/51171/4/51171_The%20impact%20of%20fluid%20balances%20in%20the%20first%2048%20hours_Scopus.pdf

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spelling	iium-511712017-04-06T08:10:26Z http://irep.iium.edu.my/51171/ The impact of fluid balances in the first 48 hours on mortality in the critically ill patients Md Ralib, Azrina Hamzah, Norhalini Nasir, Majdiah Syahirah Mat Nor, Mohd Basri R Medicine (General) Introduction: There has been increasing evidence of detrimental effects of cumulative positive fluid balance in critically ill patients. The postulated mechanism of harm is the development of interstitial oedema, with resultant increase morbidity and mortality. We aim to assess the impact of positive fluid balance within the first 48 hours on mortality in our local ICU population. Methods: This was a secondary analysis of a single centre, prospective observational study. All ICU patients more than 18 years were screened for inclusion in the study. Admission of less than 48 hours, post-elective surgery and ICU readmission were excluded. Cumulative fluid balance either as volume or percentage of body weight from admission was calculated over 6, 24 and 48 hour period from ICU admission. Results: A total of 143 patients were recruited, of these 33 died. There were higher cumulative fluid balances at 6, 24 and 48 hours in non- survivors compared to survivors. However, after adjusted for severity of illness, APACHE II Score, they were not predictive of mortality. Sensitivity analysis on sub-cohort of patients with acute kidney injury (AKI) showed only an actual 48-hour cumulative fluid balance was independently predictive of mortality (1.21 (1.03 to 1.42)). Conclusions: Cumulative fluid balance was not independently predictive of mortality in a heterogenous group of critically ill patients. However, in subcohort of patients with AKI, a 48-hour cumulative fluid balance was independently predictive of mortality. An additional tile is thus added to the mosaic of findings on the impact of fluid balance in a hetergenous group of critically ill patients, and in sub- cohort of AKI patients. International Islamic University Malaysia 2016-06-01 Article PeerReviewed application/pdf en http://irep.iium.edu.my/51171/1/51171_-_The_impact_of_fluid_balances_in_the_first_48_hours_on_mortality_in_the_critically_ill_patient.pdf application/pdf en http://irep.iium.edu.my/51171/4/51171_The%20impact%20of%20fluid%20balances%20in%20the%20first%2048%20hours_Scopus.pdf Md Ralib, Azrina and Hamzah, Norhalini and Nasir, Majdiah Syahirah and Mat Nor, Mohd Basri (2016) The impact of fluid balances in the first 48 hours on mortality in the critically ill patients. International Medical Journal Malaysia, 15 (1). pp. 13-18. ISSN 1823-4631 http://iiumedic.net/imjm/v1
repository_type	Digital Repository
institution_category	Local University
institution	International Islamic University Malaysia
building	IIUM Repository
collection	Online Access
language	English English
topic	R Medicine (General)
spellingShingle	R Medicine (General) Md Ralib, Azrina Hamzah, Norhalini Nasir, Majdiah Syahirah Mat Nor, Mohd Basri The impact of fluid balances in the first 48 hours on mortality in the critically ill patients
description	Introduction: There has been increasing evidence of detrimental effects of cumulative positive fluid balance in critically ill patients. The postulated mechanism of harm is the development of interstitial oedema, with resultant increase morbidity and mortality. We aim to assess the impact of positive fluid balance within the first 48 hours on mortality in our local ICU population. Methods: This was a secondary analysis of a single centre, prospective observational study. All ICU patients more than 18 years were screened for inclusion in the study. Admission of less than 48 hours, post-elective surgery and ICU readmission were excluded. Cumulative fluid balance either as volume or percentage of body weight from admission was calculated over 6, 24 and 48 hour period from ICU admission. Results: A total of 143 patients were recruited, of these 33 died. There were higher cumulative fluid balances at 6, 24 and 48 hours in non- survivors compared to survivors. However, after adjusted for severity of illness, APACHE II Score, they were not predictive of mortality. Sensitivity analysis on sub-cohort of patients with acute kidney injury (AKI) showed only an actual 48-hour cumulative fluid balance was independently predictive of mortality (1.21 (1.03 to 1.42)). Conclusions: Cumulative fluid balance was not independently predictive of mortality in a heterogenous group of critically ill patients. However, in subcohort of patients with AKI, a 48-hour cumulative fluid balance was independently predictive of mortality. An additional tile is thus added to the mosaic of findings on the impact of fluid balance in a hetergenous group of critically ill patients, and in sub- cohort of AKI patients.
format	Article
author	Md Ralib, Azrina Hamzah, Norhalini Nasir, Majdiah Syahirah Mat Nor, Mohd Basri
author_facet	Md Ralib, Azrina Hamzah, Norhalini Nasir, Majdiah Syahirah Mat Nor, Mohd Basri
author_sort	Md Ralib, Azrina
title	The impact of fluid balances in the first 48 hours on mortality in the critically ill patients
title_short	The impact of fluid balances in the first 48 hours on mortality in the critically ill patients
title_full	The impact of fluid balances in the first 48 hours on mortality in the critically ill patients
title_fullStr	The impact of fluid balances in the first 48 hours on mortality in the critically ill patients
title_full_unstemmed	The impact of fluid balances in the first 48 hours on mortality in the critically ill patients
title_sort	impact of fluid balances in the first 48 hours on mortality in the critically ill patients
publisher	International Islamic University Malaysia
publishDate	2016
url	http://irep.iium.edu.my/51171/ http://irep.iium.edu.my/51171/ http://irep.iium.edu.my/51171/1/51171_-_The_impact_of_fluid_balances_in_the_first_48_hours_on_mortality_in_the_critically_ill_patient.pdf http://irep.iium.edu.my/51171/4/51171_The%20impact%20of%20fluid%20balances%20in%20the%20first%2048%20hours_Scopus.pdf
first_indexed	2023-09-18T21:12:25Z
last_indexed	2023-09-18T21:12:25Z
_version_	1777411340552372224

The impact of fluid balances in the first 48 hours on mortality in the critically ill patients

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