Association between fluid overload and delirium/coma in mechanically ventilated patients

Area of Science:

• Critical Care Medicine
• Intensive Care Unit Research
• Patient Outcomes

Background:

• Fluid overload (FO) is associated with adverse outcomes in critically ill patients, including mortality and prolonged mechanical ventilation.
• The impact of FO on delirium duration in this population is not well understood.

Purpose of the Study:

• To investigate the association between fluid overload and the duration of delirium and coma days (DCDs) in mechanically ventilated patients.

Main Methods:

• Retrospective observational cohort study at University of Tsukuba Hospital (April 2015-March 2017).
• Included 118 mechanically ventilated patients with ICU stays >7 days.
• Used Mann-Whitney U test, Fisher's exact test, and multivariate proportional odds logistic regression to analyze FO and DCDs.

Main Results:

• Fluid overload occurred in 40% of patients, with the FO group showing higher APACHE II scores.
• The FO group experienced longer delirium days (2 vs 1) and DCDs (6 vs 4) within 7 days.
• Multivariate analysis revealed a significant association between FO and increased DCDs (OR, 2.16; 95% CI, 1.05-4.47).

Conclusions:

• Fluid overload is significantly associated with increased delirium and coma days in mechanically ventilated critically ill patients.
• These findings highlight the potential impact of fluid management on neurological outcomes in the ICU.