Critical Care and Shock

Positive cumulative fluid balance is a risk factor of mortality in critically septic patients


Objective: Excessive fluid administration may increase septic patient mortality. Cumulative fluid balance is an easy, cheap, and non-invasive method of monitoring fluid therapy. Our study aimed to analyze the association between cumulative fluid balance and mortality in critically septic patient.

Design: This was an observational analytic study with a retrospective cohort design.

Setting: This study was conducted in intensive care unit of Mohammad Hoesin Hospital in 2017.

Patients and participants: All adult septic patients from January to December 2017 were included. All patients who did not have completed medical record data were excluded.

Interventions: Data on the mortality and cumulative fluid balance of septic patients were obtained through secondary medical record data and were analyzed using SPSS Statistics version 22.0 (IBM, New York, US).

Measurement and results: Positive cumulative fluid has a very significant association with mortality (relative risk [RR] 3.41; 95% confidence interval [CI] 1.98-5.87; p<0.001). Mean cumulative fluid balance (ml) were greater in non-survivor than survivor group (1937.5±1692.6 vs 877.2±1228). The probability of survival in 28 days was affected by cumulative fluid balance (p=0.001) after being tested with Mantel Haenszel log-rank test. This cumulative fluid balance had a sensitivity of 81.8% and specificity of 89.2% as a predictor of mortality in septic patients.

Conclusions: Positive cumulative fluid balance can be considered as the risk factor to septic patient mortality.