ArticleCritical care (London, England)2016
The Dose Response Multicentre Investigation on Fluid Assessment (DoReMIFA) in critically ill patients.
Article in Critical care (London, England), 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 59 papers.
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Who cites it
59 citing papers in PubMed.
- Non-interventional follow-up versus fluid bolus in RESPONSE to oliguria in hemodynamically stable critically ill patients: a randomized controlled pilot trial.Critical care (London, England) · 2022Trial
- A randomized trial of albumin infusion to prevent intradialytic hypotension in hospitalized hypoalbuminemic patients.Critical care (London, England) · 2021Trial
- Small volume resuscitation with 20% albumin in intensive care: physiological effects : The SWIPE randomised clinical trial.Intensive care medicine · 2018Trial
- Feasibility and acceptability of weight-based net fluid removal during continuous kidney replacement therapy: A nursing survey.Applied nursing research : ANR · 2026Article
- Ultrafiltration in the critically ill patient: a framework for personalized care.Critical care (London, England) · 2026Review
- Research Progress on Signalling Pathways Related to Sepsis-Associated Acute Kidney Injury in Children.Current issues in molecular biology · 2025Review
- Article
- Re-exploring the association between the central venous pressure and the risk of sepsis-associated acute kidney injury according to the latest definition: Analysis of the MIMIC-IV database.Pakistan journal of medical sciences · 2025Article
- Persistent severe acute kidney injury is a major modifiable determinant of outcome during critical illness.Intensive care medicine · 2025Article
- Ultrafiltration Tolerance and Improving Outcomes with Continuous Renal Replacement Therapies.Clinical journal of the American Society of Nephrology : CJASN · 2025Article
- Understanding fluid dynamics and renal perfusion in acute kidney injury management.Journal of clinical monitoring and computing · 2025Review
- Continuous Kidney Replacement Therapy in Pediatric Intensive Care Unit: Little People, Big Gaps.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2024Article
- Point-of-care ultrasonography spotlight: Could venous excess ultrasound serve as a shared language for internists and intensivists?World journal of critical care medicine · 2024Review
- Sepsis-Associated Acute Kidney Injury: Where Are We Now?Medicina (Kaunas, Lithuania) · 2024Review
- Association between volume status assessed by bioelectrical impedance analysis, lung ultrasound, or weight change and mortality in patients with sepsisassociated acute kidney injury receiving continuous kidney replacement therapy.Kidney research and clinical practice · 2024Article
- Epidemiology of surgery associated acute kidney injury (EPIS-AKI): a prospective international observational multi-center clinical study.Intensive care medicine · 2023Observational
- Pulmonary, circulatory and renal considerations in the early postoperative management of the lung transplant recipient.Global cardiology science & practice · 2023Review
- Sepsis-associated acute kidney injury: consensus report of the 28th Acute Disease Quality Initiative workgroup.Nature reviews. Nephrology · 2023Review
- Fluid removal tolerance during the de-escalation phase: is preload unresponsiveness the best guiding candidate?Critical care (London, England) · 2023Article
- Fluid Overload and Precision Net Ultrafiltration in Critically Ill Patients.Cardiorenal medicine · 2023Review
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Authors and funding
16 authors.
Funding
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Abstract
backgroundThe previously published "Dose Response Multicentre International Collaborative Initiative (DoReMi)" study concluded that the high mortality of critically ill patients with acute kidney injury (AKI) was unlikely to be related to an inadequate dose of renal replacement therapy (RRT) and other factors were contributing. This follow-up study aimed to investigate the impact of daily fluid balance and fluid accumulation on mortality of critically ill patients without AKI (N-AKI), with AKI (AKI) and with AKI on RRT (AKI-RRT) receiving an adequate dose of RRT.
methodsWe prospectively enrolled all consecutive patients admitted to 21 intensive care units (ICUs) from nine countries and collected baseline characteristics, comorbidities, severity of illness, presence of sepsis, daily physiologic parameters and fluid intake-output, AKI stage, need for RRT and survival status. Daily fluid balance was computed and fluid overload (FO) was defined as percentage of admission body weight (BW). Maximum fluid overload (MFO) was the peak value of FO.
resultsWe analysed 1734 patients. A total of 991 (57 %) had N-AKI, 560 (32 %) had AKI but did not have RRT and 183 (11 %) had AKI-RRT. ICU mortality was 22.3 % in AKI patients and 5.6 % in those without AKI (p < 0.0001). Progressive fluid accumulation was seen in all three groups. Maximum fluid accumulation occurred on day 2 in N-AKI patients (2.8 % of BW), on day 3 in AKI patients not receiving RRT (4.3 % of BW) and on day 5 in AKI-RRT patients (7.9 % of BW). The main findings were: (1) the odds ratio (OR) for hospital mortality increased by 1.075 (95 % confidence interval 1.055-1.095) with every 1 % increase of MFO. When adjusting for severity of illness and AKI status, the OR changed to 1.044. This phenomenon was a continuum and independent of thresholds as previously reported. (2) Multivariate analysis confirmed that the speed of fluid accumulation was independently associated with ICU mortality. (3) Fluid accumulation increased significantly in the 3-day period prior to the diagnosis of AKI and peaked 3 days later.
conclusionsIn critically ill patients, the severity and speed of fluid accumulation are independent risk factors for ICU mortality. Fluid balance abnormality precedes and follows the diagnosis of AKI.
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