机构:[1]Center for Cardiac Intensive Care, Beijing Anzhen Hospital, Capital Medical University, Beijing, China临床科室心脏外科危重症中心首都医科大学附属安贞医院[2]Department of Cardiovascular Surgery, National Center for Cardiovascular Diseases and Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China[3]Intensive Care Unit, Fuxing Hospital, Capital Medical University, Beijing, China
Background: Early fluid expansion could prevent postoperative organ hypoperfusion. However, excessive fluid resuscitation adversely influences multiple organ systems. This retrospective, observational study aimed to investigate the relationship between early negative fluid balance and postoperative mortality in critically ill adult patients following cardiovascular surgery. Methods: In total, 567 critically ill patients who had undergone cardiovascular surgery and whose intensive care unit length of stay (LOS) was more than 24 hours were enrolled. The baseline characteristics, daily fluid balance and cumulative fluid balance were obtained. Patients were followed until discharge or day 28. Multivariate logistic regressions adjusted by propensity score were used to analyze the relationship between early negative fluid balance and postoperative mortality. Results: Overall, postoperative mortality was 6.2% (35/567). Acute Physiology and Chronic Health Evaluation II on admission (odd ratios [OR] 1.110), acute kidney injury stage (OR 1.639) and renal replacement therapy received (OR 3.922) were the independent risk factors of postoperative mortality, whereas negative daily fluid balance at day 2 (OR 0.411) was the protective factor. Patients with a negative daily fluid balance at day 2 had lower postoperative mortality (3.4% vs. 12.2% in the positive fluid balance group), lower acute kidney injury (AKI) stage, were less likely to receive renal replacement therapy (RRT) and experienced shorter hospital LOS compared with those with a daily positive fluid balance. Conclusion: This retrospective, observational study indicates that early negative fluid balance is associated with lower postoperative mortality in critically ill patients following cardiovascular surgery. Further prospective, randomized trials are needed to prove the benefits from the restrictive fluid management strategy.
基金:
Beijing Municipal Science & Technology CommissionBeijing Municipal Science & Technology Commission [Z161100000516017]
语种:
外文
被引次数:
WOS:
PubmedID:
中科院(CAS)分区:
出版当年[2017]版:
大类|4 区医学
小类|4 区心脏和心血管系统4 区外周血管病
最新[2023]版:
大类|4 区医学
小类|4 区心脏和心血管系统4 区外周血管病
JCR分区:
出版当年[2016]版:
Q4PERIPHERAL VASCULAR DISEASEQ4CARDIAC & CARDIOVASCULAR SYSTEMS
第一作者机构:[1]Center for Cardiac Intensive Care, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
共同第一作者:
通讯作者:
通讯机构:[1]Center for Cardiac Intensive Care, Beijing Anzhen Hospital, Capital Medical University, Beijing, China[*1]Center for Cardiac Intensive Care, Beijing Anzhen Hospital, Capital Medical University, 2 Anzhen Rd, Chaoyang District, Beijing, 100029, P.R. China.
推荐引用方式(GB/T 7714):
Chenglong Li,Hong Wang,Nan Liu,et al.Early negative fluid balance is associated with lower mortality after cardiovascular surgery[J].PERFUSION-UK.2018,33(8):630-637.doi:10.1177/0267659118780103.
APA:
Chenglong Li,Hong Wang,Nan Liu,Ming Jia,Haitao Zhang...&Xiaotong Hou.(2018).Early negative fluid balance is associated with lower mortality after cardiovascular surgery.PERFUSION-UK,33,(8)
MLA:
Chenglong Li,et al."Early negative fluid balance is associated with lower mortality after cardiovascular surgery".PERFUSION-UK 33..8(2018):630-637