Evidence map›Paper›PMID 33213268›Full record

ArticleJournal of intensive care medicine2022

The Effect of Body Mass Index and Weight-Adjusted Fluid Dosing on Mortality in Sepsis.

Michael A Ward, Hani I Kuttab, Joseph D Lykins V, Kristen Wroblewski, Michelle D Hughes, Eric P Keast, Jason A Kopec, Erron M Rourke, John Purakal

Open access · greenAbstract read
In one paragraph

Article in Journal of intensive care medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
0.6field-weighted citation impact, top 30% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 7 citations in OpenAlex.

  1. Article
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  4. Review
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 7 institutions in 1 country.

Michael A WardBerbeeWalsh Department of Emergency Medicine, 5232University of Wisconsin-Madison, Madison, WI, USA.
Hani I KuttabBerbeeWalsh Department of Emergency Medicine, 5232University of Wisconsin-Madison, Madison, WI, USA.ORCID https://orcid.org/0000-0001-9776-8929
Joseph D Lykins VDepartment of Emergency Medicine and Internal Medicine, 6887Virginia Commonwealth University Health System, Richmond, VA, USA.
Kristen WroblewskiDepartment of Public Health Sciences, 21727University of Chicago, Chicago, IL, USA.
Michelle D HughesBerbeeWalsh Department of Emergency Medicine, 5232University of Wisconsin-Madison, Madison, WI, USA.
Eric P KeastDivision of Emergency Medicine, 3271NorthShore University HealthSystem, Evanston, IL, USA.
Jason A KopecDivision of Emergency Medicine, 8100Carle Foundation Hospital, Urbana, IL, USA.
Erron M RourkeSection of Emergency Medicine, 21727University of Chicago, Chicago, IL, USA.
John PurakalDivision of Emergency Medicine, Duke University Medical Center, Durham, NC, USA.
University of Wisconsin–Madison · USCarle Foundation Hospital · USChicago Department of Public Health · USDuke Medical Center · USNorthShore University HealthSystem · USUniversity of Chicago · USVirginia Commonwealth University · US

Funding

The Institute for Translational MedicineUL1TR002389 · NCATS · UNIVERSITY OF CHICAGO · PI Joshua J Jacobs, DAVID O MELTZER · 2017 to 2026
$71.6M
NCATS NIH HHS UL1 TR002389
6 · The paper itself

Abstract

purposeThe Surviving Sepsis Campaign guidelines recommend 30 mL/kg of fluids within 3 hours (30by3) of sepsis-induced hypoperfusion, but a national mandate released an allowance for dosing based on ideal instead of actual body weight (IBW/ABW) for obese patients. This study aims to determine the dose-effect of 30by3 for patients with severe sepsis or septic shock (SS/SS) with respect to body mass index (BMI) categories and secondarily, examine the clinical impact of IBW vs. ABW-based dosing.

methodsRetrospective cohort study of adults (≥18 years; n = 1,032) with SS/SS presenting to an urban, tertiary-care emergency department. Models include MEDS score, antibiotic timing, lactate, renal and heart failure, among others.

resultsThe cohort was 10.2% underweight and 28.7% obese. Overall mortality was 17.1% with 20.4% shock mortality. An exponential increase in mortality was observed for each 5 mL/kg under 30by3 for underweight (

conclusionsAn exponential, dose-effect increase in mortality was observed for underweight patients not receiving 30by3. Therefore, the mortality impact of under-dosing may be amplified using ABW for underweight patients. Fluid dosing did not impact mortality for obese patients, but we caution against deviation from guidelines without further studies.

Indexed as

ObesityOverweightSepsisAdultBody Mass IndexHumansRetrospective Studiesbody mass indexfluid resuscitationmortalityobesitysepsis

Identifiers

PMID33213268
PMCPMC8134624
OpenAlexW3098140264

What OpenQuestion holds

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Registered trials

None linked

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.