In intensive care unit patents hipervolemia and mortality

INTRIDUCTION: Recent studies have reported increases in mortality rates associated with hypervolemia in patients followed in intensive care units. These studies are generally focused on the first few days of fluid balance in patients with sepsis, and there are no studies that follow the volume balance during the entire hospitalization. In our study, we examined the fluid balances of the patients during the entire hospitalization until their death or transfer from the intensive care unit to the service and other factors that will affect mortality. METHOD: In our study, the data of surviving and dying patients who were hospitalized in the intensive care units of TOGU Faculty of Medicine between July 2021 and October 2022 were retrospectively analyzed. A total of 61 patients were included in the study. The follow-up period of the patients was 28 days at the most. Patients who stayed longer than 28 days and subsequently died were considered survivors of 28-day mortality. The vital signs of the participants, the physical examination findings of hypervolemia, the amount of fluids taken and removed during hospitalization, fluid balances, imaging methods, whether they were connected to a ventilator, nephrotoxic drugs and agents they took, vasoconstrictive drugs and diuretic treatments, and dialysis treatments were recorded.. Frequencies of hypervolemia and mortality were compared by using Chi-Square test for categorical data, Man Whitney U test for parametric data, and Student T test for nonparametric measurements. RESULTS: Our study was completed with a total of 61 patients. While 46 (75%) of these patients were hypervolemic, 15 (25%) patients did not have hypervolemia. While 87% of hypervolemic patients died, this rate was 53% in non-hypervolemic patients. Presence of infection, dose of norepinephrine use, amount of fluid excreted by patients, mean systolic and diastolic blood pressure were associated with both hypervolemia and mortality. The frequency and dose of diuretic and steradine were higher in hypervolemic patients. The mean daily urine output of the patients with exitus was less than the survivors. Patients who died were older people, although not statistically significant. CONCLUSION: In the development of hypervolemia in intensive care patients, factors such as heart failure, infection, excessive fluid administration, and the development of AKI become more prominent. Prolongation of hospital stay increases both the frequency of hypervolemia and the mortality rate. The mortality rate was found to be lower in patients with an average daily fluid output of 1,8 liters/days. KEYWORDS: Hypervolemia, survival, positive fluid balance