NDLI: Fluid balance and cardiac function in septic shock as predictors of hospital mortality

Content Provider	Springer Nature : BioMed Central
Author	Micek, Scott T McEvoy, Colleen McKenzie, Matthew Hampton, Nicholas Doherty, Joshua A Kollef, Marin H
Abstract	Introduction Septic shock is a major cause of morbidity and mortality throughout the world. Unfortunately, the optimal fluid management of septic shock is unknown and currently is empirical. Methods A retrospective analysis was performed at Barnes-Jewish Hospital (St. Louis, Missouri). Consecutive patients (n = 325) hospitalized with septic shock who had echocardiographic examinations performed within 24 hours of shock onset were enrolled. Results A total of 163 (50.2%) patients with septic shock died during hospitalization. Non-survivors had a significantly larger positive net fluid balance within the 24 hour window of septic shock onset (median (IQR): 4,374 ml (1,637 ml, 7,260 ml) vs. 2,959 ml (1,639.5 ml, 4,769.5 ml), P = 0.004). The greatest quartile of positive net fluid balance at 24 hours and eight days post-shock onset respectively were found to predict hospital mortality, and the greatest quartile of positive net fluid balance at eight days post-shock onset was an independent predictor of hospital mortality (adjusted odds ratio (AOR), 1.66; 95% CI, 1.39 to 1.98; P = 0.004). Survivors were significantly more likely to have mild left ventricular dysfunction as evaluated by bedside echocardiography and non-survivors had slightly elevated left ventricular ejection fraction, which was also found to be an independent predictor of outcome. Conclusions Our data confirms the importance of fluid balance and cardiac function as outcome predictors in patients with septic shock. A clinical trial to determine the optimal administration of intravenous fluids to patients with septic shock is needed.
Related Links	https://ccforum.biomedcentral.com/counter/pdf/10.1186/cc13072.pdf
Ending Page	9
Page Count	9
Starting Page	1
File Format	HTM / HTML
ISSN	13648535
DOI	10.1186/cc13072
Journal	Critical Care
Issue Number	5
Volume Number	17
Language	English
Publisher	BioMed Central
Publisher Date	2013-10-20
Access Restriction	Open
Subject Keyword	Intensive Critical Care Medicine Emergency Medicine Septic Shock Propensity Score Hospital Mortality Right Ventricle Central Venous Pressure
Content Type	Text
Resource Type	Article
Subject	Critical Care and Intensive Care Medicine
Journal Impact Factor	8.8/2023
5-Year Journal Impact Factor	10.4/2023

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