Positive Fluid Balance Is Associated With Poor Outcomes in Subarachnoid Hemorrhage

Kissoon, Narayan R.; Mandrekar, Jay; Fugate, Jennifer E.; Lanzino, Giuseppe; Wijdicks, Eelco F. M.; Rabinstein, Alejandro A.

doi:10.1016/j.jstrokecerebrovasdis.2015.05.027

Cited by 53 publications

(24 citation statements)

References 42 publications

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“…In a multicenter cohort study, Payen et al [4] reported that positive FB is strongly associated with increased 60-day mortality in patients with acute renal failure. Similar results are also confirmed in other disease categories, such as ASH [16] and cancer [17], and in critically ill surgical patients [7, 18]. …”

Section: Discussionsupporting

confidence: 77%

Association between fluid intake and mortality in critically ill patients with negative fluid balance: a retrospective cohort study

Shen

Huang²,

Zhang

2017

Crit Care

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BackgroundCompared to positive fluid balance (FB), negative FB is associated with improved clinical outcomes in critically ill patients. However, as to whether achieving more negative FB can further improve outcomes has not been investigated. This study aimed to investigate whether more negative FB and restricted fluid intake were associated with improved outcomes in critically ill patients.MethodData were extracted from the Multi-parameter Intelligent Monitoring in Intensive Care III Database. Patients achieving negative FB at 48 hours after intensive care unit (ICU) admission were screened. The primary outcome was hospital mortality. Logistic models were built to explore the association between FB, fluid intake and mortality, using FB and fluid intake (both four levels) as design variables and using the linear spline function method.ResultsThere were 2068 patients meeting the inclusion criteria. Compared to slight negative FB (level 1), there was a decreased tendency towards mortality with FB level 2 (OR 0.88, 95% CI 0.69–1.11) and level 3 (OR 0.79, 95% CI 0. 65–1.11); however, only extreme negative FB (level 4) was significant (OR 0.56, 95% CI 0. 33–0.95). Fluid intake and urine output were evenly distributed over the first 48 hours after ICU admission. Fluid intake was inversely associated with hospital mortality, with the OR decreased stepwise from level 2 (OR 0.73, 95% CI 0.56–0.96) to level 4 (OR 0.47, 95% CI 0.30–0.74), referred to level 1. Urine output also showed a similar pattern. Diuretic use was associated with higher mortality in both models.ConclusionIn critically ill patients with negative FB, both increased fluid intake and urine output were associated with decreased hospital mortality. However, compared to slight FB, achieving more negative FB was not associated with reduced mortality.Electronic supplementary materialThe online version of this article (doi:10.1186/s13054-017-1692-3) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 77%

Association between fluid intake and mortality in critically ill patients with negative fluid balance: a retrospective cohort study

Shen

Huang²,

Zhang

2017

Crit Care

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“…A previous study showed that a positive liquid balance is associated with poor outcome in patients with aSAH 21 . Also other studies critically scrutinized the effects of hypervolemic therapy for vasospasm after aSAH as only a slight effect on cerebral oxygenation and cerebral blood flow was observed 21–24 . These results are in common with the data of this study as we disclosed a correlation of positive liquid balance to infarct volumes.…”

Section: Discussionmentioning

confidence: 94%

Safe Brain Tumor Resection Does not Depend on Surgery Alone - Role of Hemodynamics

Bette

Wiestler

Mayinger

et al. 2017

Sci Rep

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Aim of this study was to determine if perioperative hemodynamics have an impact on perioperative infarct volume and patients’ prognosis. 201 cases with surgery for a newly diagnosed or recurrent glioblastoma were retrospectively analyzed. Clinical data and perioperative hemodynamic parameters, blood tests and time of surgery were recorded. Postoperative infarct volume was quantitatively assessed by semiautomatic segmentation. Mean diastolic blood pressure (dBP) during surgery (rho −0.239, 95% CI −0.11 – −0.367, p = 0.017), liquid balance (rho 0.236, 95% CI 0.1–0.373, p = 0.017) and mean arterial pressure (MAP) during surgery (rho −0.206, 95% CI −0.07 – −0.34, p = 0.041) showed significant correlation to infarct volume. A rank regression model including also age and recurrent surgery as possible confounders revealed mean intraoperative dBP, liquid balance and length of surgery as independent factors for infarct volume. Univariate survival analysis showed mean intraoperative dBP and MAP as significant prognostic factors, length of surgery also remained as significant prognostic factor in a multivariate model. Perioperative close anesthesiologic monitoring of blood pressure and liquid balance is of high significance during brain tumor surgery and should be performed to prevent or minimize perioperative infarctions and to prolong survival.

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“…Hyponatremia and dehydration due to natriuresis after aSAH is related to SVS and predicts of SVS [9][10][11][12][13][14][15]. In addition, both hypernatremia and hypervolemia after SAH are associated with poor outcome [16,17]. Therefore, nowadays most institutions target to euvolemia and eunatremia in a SAH patients to avoid complications.…”

Section: Introductionmentioning

confidence: 99%

Decreased serum sodium levels predict symptomatic vasospasm in patients with subarachnoid hemorrhage

Uozumi

Mizobe

Miyamoto

et al. 2017

Journal of Clinical Neuroscience

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Positive Fluid Balance Is Associated With Poor Outcomes in Subarachnoid Hemorrhage

Cited by 53 publications

References 42 publications

Association between fluid intake and mortality in critically ill patients with negative fluid balance: a retrospective cohort study

Association between fluid intake and mortality in critically ill patients with negative fluid balance: a retrospective cohort study

Safe Brain Tumor Resection Does not Depend on Surgery Alone - Role of Hemodynamics

Decreased serum sodium levels predict symptomatic vasospasm in patients with subarachnoid hemorrhage

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