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Association of Fluid Overload with Mortality in Critically-ill Mechanically Ventilated Children

Sukla Samaddar1, Jhuma Sankar1, Sushil Kumar Kabra1

  • 1Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India.

Indian Pediatrics
|December 28, 2018
PubMed

Insights

Fluid overload in critically-ill children on mechanical ventilation is not linked to mortality. However, it is associated with worse organ function and longer hospital stays.

Area of Science:

  • Pediatric Critical Care Medicine
  • Fluid Management in Pediatrics
  • Mechanical Ventilation Outcomes

Background:

  • Fluid overload is a common complication in critically-ill children requiring mechanical ventilation.
  • Understanding the impact of fluid overload on patient outcomes is crucial for optimizing care.

Purpose of the Study:

  • To investigate the association between fluid overload and mortality in critically-ill, mechanically ventilated children.
  • To explore the relationship between fluid overload and secondary outcomes including organ dysfunction, oxygenation, and duration of mechanical ventilation and PICU stay.

Main Methods:

  • A prospective observational study was conducted in a Pediatric Intensive Care Unit (PICU).
  • 118 children aged 1 month to 15 years requiring mechanical ventilation were included.
  • Fluid overload was assessed, and associations with mortality and morbidity were analyzed.

Main Results:

  • 62.7% of children experienced cumulative fluid overload of ≥15%, often within the first 5 days.
  • Fluid overload ≥15% was associated with higher maximum pediatric logistic organ dysfunction (PELOD) scores.
  • Fluid overload was linked to significantly longer durations of mechanical ventilation and PICU stay, but not mortality or oxygenation index.

Conclusions:

  • Fluid overload in critically-ill, mechanically ventilated children is not associated with increased mortality.
  • Fluid overload is significantly associated with poorer organ function and prolonged mechanical ventilation and PICU length of stay.
Abstract

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