Positive fluid balance in sepsis and its effects

Abstract

Background: Fluid replacement is vital for stabilizing hemodynamic status in sepsis.However, the positive fluid balance may result in pulmonary edema and may be associated with increased mortality. Puırpose:To identify the effect of positive fluid balance on extubation and survival of patients with sepsis. Materials and methods:This is a single-center, retrospective study in which the patients, supported with mechanical ventilation (MV) due to sepsis, were enrolled. All the data about the demographic features, medications, MV duration, vital signs, blood gas analysis, blood tests, the fluid balance were obtained from the patient files and nursery reports.Results: A total of fifty patients with sepsis were included in the study. Twenty-six (52%) were male and the mean age was 66.58±3.25 years. The mortality rate was 90%. There was no difference between survivors and nonsurvivors in respect to fluid balance. ICU stay length and MV stay length were also similar in patients with positive fluid balance and negative fluid balance. The use of diuretics was significantly higher in patients with positive fluid balance (p=0.023). CRP was significantly higher while serum albumin was lower in patients with positive fluid balance (respectively, p=0.003, p=0.034). There was no difference between the mean GCS, SOFA scores of survivors and nonsurvivors but the mean APACHE II scores in nonsurvivors were significantly higher than in survivors (p=0.026). Conclusion:In our study, we observed that the positive fluid balance did not affect mortality and APACHE II seems to be better to predict mortality, than SOFA and GCS.