P018. Intensive care unit (SICU) of a tertiary care hospital effect of fluid balance on outcome of patients admitted to the surgical

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Background: Fluid balance remains a highly controversial topic in the critical care field, and there is no consensus about the amount of fluid required by critically ill patients.
Objectives: In this study, the objective was to find the relationship between fluid balance and in hospital mortality in critically ill surgical patients. Our secondary objective was to identify the association between use of colloid and acute kidney injury and use of blood products and development of ARDS.
Methods: The medical records of adult patients admitted to a surgical intensive care unit (ICU) ≥ 48 hours, from August 2014 to February 2016 (18 months) were reviewed retrospectively. The study was conducted in the surgical intensive care unit of a tertiary care hospital .Medical records of 18 months from August 2014 to February 2016 were reviewed. Abstracted data of patients admitted to surgical intensive care included body mass index, Acute Physiology and Chronic Health Evaluation (APACHE) II scores, fluid balance during first 5 days of ICU stay, length of ICU stay and in hospital mortality. All statistical analysis was performed using statistical packages for social science version 19 (SPSS Inc., Chicago, IL). Frequency and percentage were computed for qualitative observation and were analyze by chi square test. Mean (± standard deviation) and median (IQR) were presented for quantitative variables and analyze by independent sample t test and Mann-Whitney test. Normality of quantitative data was also be checked by Kolmogorov-Smirnov test. Statistically significant results had a P-value less than 0.05.
Results: A total of 100 patients fulfilled the inclusion criteria. The average age of patients was 44.08 ± 18.14 (years), BMI (kg m-2) 27.84 ± 5.56 and APACHE II Score 17.28 ± 6.96. The in hospital mortality was 26%, median length of ICU and hospital stay was 6.91 ± 4.07 and 14.74 ± 7.78 days. In non-survivors fluid balance was significantly positive on 2nd, 3rd, 4th and 5th day of SICU (P-value: 0.005, 0.0005 and 0.024), APACHE II score (P < 0.02), incidence of acute kidney injury (P < 0.004) and mechanical ventilation days were significantly more. There was association between the of use of colloid and acute kidney injury (P < 0.014). Use of blood products was significantly associated (P < 0.03) with development of ARDS.
Conclusions: Positive fluid balance, high APACHE II score and acute kidney injury is significantly associated with hospital mortality of non-cardiac surgical ICU patients.

Publication (Name of Journal)

Anaesthesiology Intensive Therapy