ArticleCritical care medicine2014
Post-ICU admission fluid balance and pediatric septic shock outcomes: a risk-stratified analysis.
Article in Critical care medicine, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 36 papers, 3 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
36 citing papers in PubMed, 3 syntheses or guidelines pooled it, 82 citations in OpenAlex.
- Association between fluid overload and mortality in children with sepsis: a systematic review and meta-analysis.BMJ paediatrics open · 2023Pooled it
- Association Between Fluid Balance and Outcomes in Critically Ill Children: A Systematic Review and Meta-analysis.JAMA pediatrics · 2018Pooled it
- Conservative fluid management or deresuscitation for patients with sepsis or acute respiratory distress syndrome following the resuscitation phase of critical illness: a systematic review and meta-analysis.Intensive care medicine · 2017Pooled it
- Fluid balance control in critically ill patients: results from as-treated analyses of POINCARE-2 randomized trial.Critical care (London, England) · 2023Trial
- Fluid assessment, fluid balance, and fluid overload in sick children: a report from the Pediatric Acute Disease Quality Initiative (ADQI) conference.Pediatric nephrology (Berlin, Germany) · 2024Article
- Revisiting Post-ICU Admission Fluid Balance Across Pediatric Sepsis Mortality Risk Strata: A Secondary Analysis of a Prospective Observational Cohort Study.Critical care explorations · 2024Article
- Fluid Balance and Its Association With Mortality and Health-Related Quality of Life: A Nonprespecified Secondary Analysis of the Life After Pediatric Sepsis Evaluation.Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies · 2023Article
- Epidemiology, risk factors and outcomes of prolonged mechanical ventilation with different cut-points in a PICU.Frontiers in pediatrics · 2023Article
- Fluid bolus therapy in pediatric sepsis: a narrative review.European journal of medical research · 2022Review
- Medication and Fluid Management of Pediatric Sepsis and Septic Shock.Paediatric drugs · 2022Review
- Recalibration of the Renal Angina Index for Pediatric Septic Shock.Kidney international reports · 2021Article
- Pediatric acute kidney injury: new advances in the last decade.Kidney research and clinical practice · 2021Article
- Machine Learning Identifies Complicated Sepsis Course and Subsequent Mortality Based on 20 Genes in Peripheral Blood Immune Cells at 24 H Post-ICU Admission.Frontiers in immunology · 2021Article
- Proprotein Convertase Subtilisin/Kexin Type 9 Loss-of-Function Is Detrimental to the Juvenile Host With Septic Shock.Critical care medicine · 2020Article
- Prognostic and predictive enrichment in sepsis.Nature reviews. Nephrology · 2020Review
- Translational gap in pediatric septic shock management: an ESPNIC perspective.Annals of intensive care · 2019Article
- Sepsis Biomarkers.Journal of pediatric intensive care · 2019Review
- Medication Use as a Contributor to Fluid Overload in the PICU: A Prospective Observational Study.Journal of pediatric intensive care · 2018Article
- Endotype Transitions During the Acute Phase of Pediatric Septic Shock Reflect Changing Risk and Treatment Response.Critical care medicine · 2018Observational
- Elevated central venous pressure is associated with increased mortality in pediatric septic shock patients.BMC pediatrics · 2018Article
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Authors and funding
20 authors at 12 institutions in 2 countries.
Funding
Abstract
objectiveObserved associations between fluid balance and septic shock outcomes are likely confounded by initial mortality risk. We conducted a risk-stratified analysis of the association between post-ICU admission fluid balance and pediatric septic shock outcomes.
designRetrospective analysis of an ongoing multicenter pediatric septic shock clinical and biological database.
settingSeventeen PICUs in the United States. PATIENTS: Three hundred and seventeen children with septic shock.
interventionsNone. MEASUREMENTS AND MAIN
resultsWe stratified subjects into three mortality risk categories (low, intermediate, and high) using a validated biomarker-based stratification tool. Within each category, we assessed three fluid balance variables: total fluid intake/kg/d during the first 24 hours, percent positive fluid balance during the first 24 hours, and cumulative percent positive fluid balance up to 7 days. We used logistic regression to estimate the effect of fluid balance on the odds of 28-day mortality, and on complicated course, which we defined as either death within 28 days or persistence of two or more organ failures at 7 days. There were 40 deaths, and 91 subjects had a complicated course. Increased cumulative percent positive fluid balance was associated with mortality in the low-risk cohort (n = 204; odds ratio, 1.035; 95% CI, 1.004-1.066) but not in the intermediate- and high-risk cohorts. No other associations with mortality were observed. Fluid intake, percent positive fluid balance in the first 24 hours, and cumulative percent positive fluid balance were all associated with increased odds of a complicated course in the low-risk cohort but not in the intermediate- and high-risk cohorts.
conclusionsWhen stratified for mortality risk, increased fluid intake and positive fluid balance after ICU admission are associated with worse outcomes in pediatric septic shock patients with a low initial mortality risk but not in patients at moderate or high mortality risk.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.