ArticleBMC anesthesiology2021
Influence of fluid balance on the prognosis of patients with sepsis.
Article in BMC anesthesiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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12 citing papers in PubMed, 1 synthesis or guideline pooled it, 34 citations in OpenAlex.
- Fluid balance and mortality in adult ICU patients with sepsis or septic shock: a systematic review and meta-analysis of observational studies.BMC anesthesiology · 2025Pooled it
- A New Proposed Approach to Categorize Sepsis Sub-phenotypes Based on Combined Trajectories of Perfusion Index and Central Venous Oxygen Saturation.Shock (Augusta, Ga.) · 2026Article
- Development and external validation of a prediction model for major adverse kidney events within 30 days in sepsis associated acute kidney injury: a multi-center retrospective clinical study.BMC medical informatics and decision making · 2026Article
- The association of fluid balance with traumatic brain injury outcomes: A systematic review.Journal of intensive medicine · 2025Article
- Inferior vena cava distensibility during pressure support ventilation: a prospective study evaluating interchangeability of subcostal and trans‑hepatic views, with both M‑mode and automatic border tracing.Journal of clinical monitoring and computing · 2024Observational
- Fluid balance, biomarkers of renal function and mortality in critically ill patients with AKI diagnosed before, or within 24 h of intensive care unit admission: a prospective study.Journal of nephrology · 2024Article
- Prognostic value of Doppler waveform analysis of common femoral vein in septic patients: a prospective cohort study.Journal of ultrasound · 2023Article
- 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
- Inferior vena cava distensibility from subcostal and trans-hepatic imaging using both M-mode or artificial intelligence: a prospective study on mechanically ventilated patients.Intensive care medicine experimental · 2023Article
- Assessment of the inferior vena cava collapsibility from subcostal and trans-hepatic imaging using both M-mode or artificial intelligence: a prospective study on healthy volunteers.Intensive care medicine experimental · 2023Article
- Article
- Association between fluid balance and mortality for heart failure and sepsis: a propensity score-matching analysis.BMC anesthesiology · 2022Article
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Authors and funding
8 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEarly and timely fluid treatment or resuscitation are the basic measures for the active treatment of sepsis. Our aim is to further explore the relationship between fluid balance and prognosis in patients with sepsis on a daily basis for 5 days.
methodsSepsis patients in eICU Collaborative Research Database were divided into the negative balance group (NB/-) and the positive balance group (PB/+) according to daily fluid balance. The primary outcome was in-hospital mortality. Survival differences between the groups were analyzed by using Cox regression. Then dose-response relationship between fluid balance and in-hospital mortality was studied using restricted cubic splines (RCSs). Furthermore, patients with fluid balance data for the previous three consecutive days were selected and divided into eight groups ("+/+/+", "+/+/-", "+/ -/-", "+/ -/+", "-/ -/-", "-/ -/+", "-/+/+", and "-/+/-"). Kaplan-Meier curves and Cox regression were used to show the survival difference between groups.
resultsOur study, which included 19,557 patients in a multicenter database, showed that positive fluid balances on days 1, 2, and 3 after sepsis diagnosis were associated with poor prognosis with the HRs of 1.29 (1.20,1.40), 1.13 (1.01,1.27), and 1.25 (1.08,1.44), respectively, while the fluid balance on days 4 and 5 had no effect on the primary outcome. Then RCSs showed an overall trend that the risk of in-hospital mortality on days 1, 2, and 3 increased with increasing fluid balance. For three consecutive days of fluid balance, we studied 9205 patients and Kaplan-Meier curves revealed survival differences among patients in the eight groups. The cox model demonstrated that compared with the "+/+/+" group, the "+/ -/-", "-/ -/-", "-/ -/+", "-/+/+", and "-/+/-" groups had a lower risk of in-hospital mortality, with HRs of 0.65 (0.45,0.93), 0.72 (0.60,0.86), 0.63 (0.43,0.93), 0.69 (0.48,0.98), and 0.63 (0.42,0.96), respectively.
conclusionsIn patients with sepsis, positive fluid balance on days 1, 2, and 3 was associated with adverse outcomes. For patients with fluid balance for three consecutive days, the "+/-/-", "-/ -/-", "-/-/+", "-/+/+", and "-/+/-" groups were less likely to die in hospital than the "+/+/+" group.
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