ArticlePloS one2016
Association of Fluid Accumulation with Clinical Outcomes in Critically Ill Children with Severe Sepsis.
Article in PloS one, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 3 of them syntheses that pooled it.
What it found
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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
28 citing papers in PubMed, 3 syntheses or guidelines pooled it, 70 citations in OpenAlex.
- Association between fluid overload and mortality in children with sepsis: a systematic review and meta-analysis.BMJ paediatrics open · 2023Pooled it
- Global Case-Fatality Rates in Pediatric Severe Sepsis and Septic Shock: A Systematic Review and Meta-analysis.JAMA pediatrics · 2019Pooled it
- Association Between Fluid Balance and Outcomes in Critically Ill Children: A Systematic Review and Meta-analysis.JAMA pediatrics · 2018Pooled it
- Divergence Between Net Fluid and Weight-Based Evaluation in Calculating Cumulative Fluid Balance.Critical care explorations · 2026Observational
- Divergence Between Net Fluid and Weight-Based Evaluation in Calculating Cumulative Fluid Balance.medRxiv : the preprint server for health sciences · 2025Article
- Correlation between positive fluid balances with venous excess ultrasound scores and lung ultrasound in critically ill children with fluid overload.BMC pediatrics · 2025Article
- Article
- 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
- 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
- Fluid balance in critically ill children with lower respiratory tract viral infection: a cohort study.Journal of anesthesia, analgesia and critical care · 2023Article
- A Study to Compare Ultrasound-guided and Clinically Guided Fluid Management in Children with Septic Shock.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2023Article
- Fluid bolus therapy in pediatric sepsis: a narrative review.European journal of medical research · 2022Review
- Ultrasonographically derived caudal vena cava parameters acquired in a standing position and lateral recumbency in healthy, lightly sedated cats: a pilot study.Journal of feline medicine and surgery · 2022Article
- Lung Ultrasound versus Chest X-Ray for the Detection of Fluid Overload in Critically Ill Children: A Systematic Review.Journal of pediatric intensive care · 2022Review
- Prospective Cohort Study on Cumulative Fluid Balance and Outcome in Critically Ill Children Using a Restrictive Fluid Protocol.Indian journal of pediatrics · 2022Article
- Intravenous Fluid Bolus Rates Associated with Outcomes in Pediatric Sepsis: A Multi-Center Analysis.Open access emergency medicine : OAEM · 2022Article
- Association between early fluid overload and mortality in critically-ill mechanically ventilated children: a single-center retrospective cohort study.BMC pediatrics · 2021Article
- The Use of Diuretic in Mechanically Ventilated Children with Viral Bronchiolitis: a Cohort Study.Journal of critical care medicine (Universitatea de Medicina si Farmacie din Targu-Mures) · 2021Article
- Oral Spermine Supplementation in Gestated Rabbit: A Study on Villi Height of Immature Intestines.Frontiers in surgery · 2021Article
- Assessment of Volume Status and Fluid Responsiveness in Small Animals.Frontiers in veterinary science · 2021Review
Corrections and comments
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Authors and funding
10 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo evaluate whether early and acquired daily fluid overload (FO), as well as fluctuations in fluid accumulation, were associated with adverse outcomes in critically ill children with severe sepsis.
methodsThis study enrolled 202 children in a pediatric intensive care unit (PICU) with severe sepsis. Early fluid overload was defined as ≥5% fluid accumulation occurring in the first 24 hours of PICU admission. The maximum daily fluid accumulation ≥5% occurring during the next 6 days in patients with at least 48 hours of PICU stay was defined as PICU-acquired daily fluid overload. The fluctuation in fluid accumulation was calculated as the difference between the maximum and the minimum daily fluid accumulation obtained during the first 7 days after admission.
resultsOf the 202 patients, 61 (30.2%) died during PICU stay. Among all patients, 41 (20.3%) experienced early fluid overload, including 9 with a FO ≥10%. Among patients with at least 48 hours of PICU stay (n = 154), 36 (23.4%) developed PICU-acquired daily fluid overload, including 2 with a FO ≥10%. Both early fluid overload (AOR = 1.20; 95% CI 1.08-1.33; P = 0.001; n = 202) and PICU-acquired daily fluid overload (AOR = 5.47 per log increase; 95% CI 1.15-25.96; P = 0.032; n = 154) were independent risk factors associated with mortality after adjusting for age, illness severity, etc. However, fluctuations in fluid accumulation were not associated with mortality after adjustment. Length of PICU stay increased with greater fluctuations in fluid accumulation in all patients with at least 48 hours of PICU stay (FO <5%, 5%-10% vs. ≥10%: 4 [3-8], 7 [4-11] vs. 10 [6-16] days; P <0.001; n = 154) and in survivors (4 [3-8], 7 [5-11] vs. 10 [5-15] days; P <0.001; n = 121). Early fluid overload achieved an area under-the-receiver-operating-characteristic curve of 0.74 (95% CI 0.65-0.82; P <0.001; n = 202) for predicting mortality in patients with severe sepsis, with a sensitivity of 67.2% and a specificity of 80.1% at the optimal cut-off value of 2.65%.
conclusionsBoth early and acquired daily fluid overload were independently associated with PICU mortality in children with severe sepsis.
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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.