Fluid volume, fluid balance and patient outcome in severe sepsis and septic shock: A systematic review.
J Crit Care
; 48: 153-159, 2018 12.
Article
em En
| MEDLINE
| ID: mdl-30199843
ABSTRACT
PURPOSE:
This systematic review and meta-analysis was conducted to evaluate the mortality risk in severe sepsis and septic shock with a low and high fluid volume/balance.METHODS:
Cohort studies that compared the mortality of patients with low or high fluid volume/balance were included. Electronic databases PubMed/Medline PLUS, Embase, Scopus, and Web of Science were searched. Patient mortality at the longest follow-up was the primary outcome measure. The data were analyzed using STATA 14 statistical software.RESULTS:
The current study included fifteen studies with 31,443 severe sepsis and/or septic shock patients. Patients with a high fluid balance have a 70% increased risk of mortality (pooled RR 1.70; CI 1.20, 2.41; Pâ¯=â¯.003). Survivors of severe sepsis and/or septic shock received higher fluid volume in the first three hours. However, fluid volume administered in the first 24â¯h was higher for non-survivors. Low volume resuscitation in the first 24â¯h had a significant mortality reduction (Pâ¯=â¯.02).CONCLUSION:
High fluid balance from the first 24â¯h to ICU discharge increases the risk of mortality in severe sepsis and/or septic shock. However, randomized clinical trials should be conducted to resolve the dilemma of fluid resuscitation.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Sepse
Tipo de estudo:
Clinical_trials
/
Observational_studies
/
Risk_factors_studies
/
Systematic_reviews
Limite:
Humans
País como assunto:
Asia
Idioma:
En
Ano de publicação:
2018
Tipo de documento:
Article