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Updated: Nov 23, 2025
Author Spotlight: Exploring Venous Waveforms in Porcine Models to Tackle Volume Overload in Medicine
Published on: January 12, 2024
Fluid overload in a South African pediatric intensive care unit
Naomi Ketharanathan1, Mignon McCulloch2, Clare Wilson3
1Division of Intensive Care and Pediatric Surgery, Department of Pediatrics, Intensive Care Unit, Erasmus Medical Center, Sophia Children's Hospital, Rotterdam, 3015GJ, The Netherlands n.ketharanathan@gmail.com.
Objective:
Fluid resuscitation is integral to resuscitation guidelines and critical care. However, fluid overload (FO) yields increased morbidity.
Methods:
Prospective observational study of Red Cross War Memorial Children's Hospital pediatric intensive care unit admissions (February to March 2013). FO % = (fluid in minus fluid out) [liters]/weight [kg] × 100%.
Primary Outcomes:
FO ≥ 10%, 28 day mortality.
Results:
Median [interquartile range (IQR)] age: 9.5 (2.0-39.0) months, median (IQR) admission weight: 7.9 (3.6-13.7) kg. Median (IQR) FO with admission weight: 3.5 (2.1-4.9)%; three patients had FO ≥ 10%. The 28 day mortality was 10% (n = 10). Patients who died had higher mean (IQR) FO using admission weight [4.9 (2.9-9.3)% vs. 3.4 (1.9-4.8)%; p = 0.04].
Conclusions:
Low FO ≥ 10% prevalence with 28 day mortality 10%. Higher FO% with admission weight associated with mortality (p = 0.04). We advocate further investigation of FO% as a simple bedside tool.
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