NDLI: The modified effect of mechanical ventilation setting on relationship between fluid balance and hospital mortality for sepsis patients: a retrospective study

Content Provider	Springer Nature : BioMed Central
Author	Zhou, Dawei Lv, Yi Wang, Chao Li, Dan
Abstract	Background Fluid supplement may be affected by ventilatory management due to physiological interaction between heart and lung. The aim of the present study was to explore the effects of ventilator strategies on the relationship of fluid balance and hospital mortality for sepsis patients. Methods This was a retrospective cohort study included sepsis patients with invasive mechanical ventilation (MV) over 24 h from Medical Information Mart for Intensive Care (MIMIC) IV database. The accumulative fluid balance increased by 6 h intervals were calculated as fluid intake minus fluid output. The modes (assisted or controlled) and levels (high or low) of positive end-expiratory pressure (PEEP) of MV every 6 h were recorded. The modification effect for modes and levels of PEEP on the relationship of fluid balance and hospital mortality were tested by multivariable regression models, respectively. Results A total of 4466 sepsis patients with invasive MV were included, of which hospital mortality was 26.5%. Fluid balance seemed to have U-shape relationship with hospital mortality. The majority of patients used controlled ventilation at the beginning, and switched to assisted ventilation gradually; however, the PEEP level did not change a lot during the first 24 h. The relationship between fluid balance and hospital mortality was not modified by the ventilator mode; while the PEEP level may modify the relationship. Conclusions For sepsis patients admitted to ICU with invasive MV, the PEEP level, but not the mode of MV, appeared to modify the relationship of fluid balance and hospital mortality. The setting of mechanical ventilation may be an important consideration for fluid therapy.
Related Links	https://bmcanesthesiol.biomedcentral.com/counter/pdf/10.1186/s12871-025-02954-x.pdf
Ending Page	11
Page Count	11
Starting Page	1
File Format	HTM / HTML
ISSN	14712253
DOI	10.1186/s12871-025-02954-x
Journal	BMC Anesthesiology
Issue Number	1
Volume Number	25
Language	English
Publisher	BioMed Central
Publisher Date	2025-02-20
Access Restriction	Open
Subject Keyword	Anesthesiology Internal Medicine Emergency Medicine Intensive Critical Care Medicine Sepsis Mechanical ventilation Positive end-expiratory pressure Fluid balance Hospital mortality
Content Type	Text
Resource Type	Article
Subject	Anesthesiology and Pain Medicine
Journal Impact Factor	2.3/2023
5-Year Journal Impact Factor	2.6/2023

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