Fluid overload at 48 hours is associated with respiratory morbidity but not mortality in a general PICU:...

Area of Science:

• Pediatric Critical Care Medicine
• Fluid Management in Critically Ill Children
• Respiratory Morbidity and Mortality

Background:

• Fluid overload is increasingly recognized as a potential risk factor in critically ill patients.
• The impact of early fluid accumulation on respiratory outcomes and survival in pediatric intensive care unit (PICU) populations requires further investigation.

Purpose of the Study:

• To examine the association between early fluid overload and respiratory morbidity in critically ill children.
• To investigate the relationship between early fluid overload and mortality in a pediatric intensive care unit (PICU) setting.

Main Methods:

• Retrospective cohort study including 636 children (0-16 years) invasively ventilated at 48 hours post-admission.
• Fluid overload percentage calculated at 48 hours post-admission based on fluid balance and body weight.
• Outcome measures included oxygenation index, mortality, and duration of invasive ventilation in survivors.

Main Results:

• Fluid overload percentage at 48 hours was significantly correlated with a higher oxygenation index (p < 0.0001) and increased invasive ventilation days in survivors (p < 0.0001).
• Fluid overload was a significant predictor of both oxygenation index at 48 hours (p < 0.001) and invasive ventilation days (p = 0.002).
• No significant difference in fluid overload percentage was observed between survivors and non-survivors.

Conclusions:

• Early fluid overload (at 48 hours) in a general pediatric intensive care unit (PICU) population is associated with impaired oxygenation and prolonged ventilation duration.
• Fluid overload at 48 hours was not associated with mortality in this cohort of critically ill children.
• These findings highlight the importance of monitoring fluid balance for respiratory outcomes in pediatric critical care.