2015, Number 2
Water balance: a marker of clinical evolution prognostic in critically ill patients. Preliminary report
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ABSTRACTIntroduction: The fluid resuscitation in critically ill patients is vital to keep the oxygen, however the deficit or excess of water intake results in adverse clinical outcomes.
Hypothesis: The positive fluid balance is associated with increased morbidity and mortality in critically ill patients.
Objective: To analyze the association of positive water balance with morbidity and mortality in critically ill patients.
Method: A longitudinal, observational, prospective, case series of 59 patients admitted to the Intensive Care Unit (ICU) ISSEMyM Medical Center with 28-day follow-up was performed. ANOVA was used to identify the association of water balance, the physiological and biochemical characteristics of each of the groups divided based on their severity and age variables. Finally the probability of individual survival accumulated over time with the method of Kaplan and Meier, using Fisher exact test was verified the existence of a significant difference in survival between groups.
Results: Regarding the difference in survival, a reduction was no demonstrated in this one with a water balance positive at the end of the first day in ICU (p = 0.237), however with continued monitoring to three days a tendency to occur was demonstrated, although no significant (p = 0.054), but after tracking patients until discharge from the ICU, the positive water balance itself was associated with a lower survival with a statistically significant association (p = 0.000).
Conclusions: The water balance, as a prognostic marker of clinical outcome should be recognized as a potentially modifiable determinant marker and clinical outcome, once the water balance of the positive association was found with a shorter survival in critically ill patients regardless of age and severity measured by SOFA on admission.
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