ArticleCureus2025
Impact of Fluid Overload on Mortality Among Critically Ill Pediatric Patients: An Observational Study at a Tertiary Care Hospital in Central India.
Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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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.
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Who cites it
2 citing papers in PubMed.
- Bridging evidence and practice: implementation science and bundled care strategies for fluid management in critically ill neonates.Frontiers in medicine · 2026Article
- Fluid Creep as an Independent Predictor of Fluid Overload and Mortality in Critically Ill Patients: A Cohort Study.Life (Basel, Switzerland) · 2025Article
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background Fluid overload (FO) is a critical concern in pediatric intensive care units (PICUs), contributing to increased morbidity and mortality. Excessive fluid accumulation can exacerbate organ dysfunction, particularly affecting the cardiovascular, respiratory, and renal systems. While FO has been widely studied in adult populations, data on its burden, risk factors, and clinical outcomes in critically ill pediatric patients, particularly in low-resource settings like India, remain limited. This study aimed to assess the prevalence of significant cumulative FO percentage and its association with mortality, Pediatric Risk of Mortality (PRISM-III) score, and length of PICU stay. Methods This prospective observational study was conducted from June 2023 to October 2024 at the PICU of a tertiary care hospital in central India. A total of 230 children aged 1 month to 13 years who required intensive care were included. Demographic and clinical parameters, including fluid balance and PRISM-III scores, were recorded. FO was calculated based on cumulative fluid intake and output relative to baseline body weight. The association between FO and clinical outcomes was assessed using logistic regression analysis and receiver operating characteristic (ROC) curve analysis. Results The median (interquartile range (IQR)) cumulative FO at 24 hours, 48 hours, 7 days, and cumulative FO were 5.4% (3.4, 7.8), 5.3% (3.5-8), 5.7% (3.7-8.3), and 5.7% (3.7-8.4), respectively. The median PRISM-III score was 6 (IQR: 0-14). Among the 230 children, 13% died during follow-up. Non-survivors had significantly higher PRISM-III scores and FO percentages (p < 0.01). ROC analysis showed FO (area under the curve (AUC) = 0.72) and PRISM-III (AUC = 0.97) as strong mortality predictors. Multivariable regression identified 24 hours and overall cumulative FO and PRISM-III score as independent predictors of mortality. Conclusion Twenty-four-hour cumulative FO is a significant determinant of mortality in critically ill children, emphasizing the need for early monitoring and targeted management strategies in PICUs.
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