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Fluid Balance and Its Association With Mortality and Health-Related Quality of Life: A Nonprespecified Secondary Analysis of the Life After Pediatric Sepsis Evaluation.
Stenson, Erin K; Banks, Russell K; Reeder, Ron W; Maddux, Aline B; Zimmerman, Jerry; Meert, Kathleen L; Mourani, Peter M.
Afiliação
  • Stenson EK; Section of Pediatric Critical Care Medicine, Department of Pediatrics, Children's Hospital of Colorado, Aurora, CO.
  • Banks RK; Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Utah, Salt Lake City, UT.
  • Reeder RW; Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Utah, Salt Lake City, UT.
  • Maddux AB; Section of Pediatric Critical Care Medicine, Department of Pediatrics, Children's Hospital of Colorado, Aurora, CO.
  • Zimmerman J; Division of Pediatric Critical Care Medicine, Department of Pediatrics, Seattle Children's Hospital, Seattle Children's Research Institute, University of Washington School of Medicine, Seattle, WA.
  • Meert KL; Division of Pediatric Critical Care Medicine, Department of Pediatrics, Children's Hospital of Michigan, Central Michigan University, Detroit, MI.
  • Mourani PM; Section of Critical Care Medicine, Department of Pediatrics, University of Arkansas for Medical Sciences and Arkansas Children's Hospital, Little Rock, AR.
Pediatr Crit Care Med ; 24(10): 829-839, 2023 Oct 01.
Article em En | MEDLINE | ID: mdl-37260317
OBJECTIVES: To evaluate the association between fluid balance (FB) and health-related quality of life (HRQL) among children at 1 month following community-acquired septic shock. DESIGN: Nonprespecified secondary analysis of the Life After Pediatric Sepsis Evaluation. FB was defined as 100 × [(cumulative PICU fluid input - cumulative PICU fluid output)/PICU admission weight]. Three subgroups were identified: low FB (< 5%), medium FB (5%-15%), and high FB (> 15%) based on cumulative FB on days 0-3 of ICU stay. HRQL was measured at ICU admission and 1 month after using Pediatric Quality of Life Inventory 4.0 Generic Core or Infant Scales or the Stein-Jessop Functional Status Scale. The primary outcome was a composite of mortality or greater than 25% decline in HRQL 1 month after admission compared with baseline. SETTING: Twelve academic PICUs in the United States. PATIENTS: Critically ill children between 1 month and 18 years, with community-acquired septic shock who survived to at least day 4. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Two hundred ninety-three patients were included of whom 66 (23%) had low FB, 127 (43%) had medium FB, and 100 (34%) had high FB. There was no difference in Pediatric Risk of Mortality Score 3 (median 11 [6, 17]), age (median 5 [1, 12]), or gender (47% female) between FB groups. After adjusting for potential confounders and comparing with medium FB, higher odds of mortality or greater than 25% HRQL decline were seen in both the low FB (odds ratio [OR] 2.79 [1.20, 6.57]) and the high FB (OR 2.16 [1.06, 4.47]), p = 0.027. Compared with medium FB, low FB (OR 4.3 [1.62, 11.84]) and high FB (OR 3.29 [1.42, 8.00]) had higher odds of greater than 25% HRQL decline. CONCLUSIONS: Over half of the children who survived septic shock had low or high FB, which was associated with a significant decline in HRQL scores. Prospective studies are needed to determine if optimization of FB can improve HRQL outcomes.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Choque Séptico / Sepse Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Aspecto: Patient_preference Limite: Child / Female / Humans / Infant / Male Idioma: En Revista: Pediatr Crit Care Med Assunto da revista: PEDIATRIA / TERAPIA INTENSIVA Ano de publicação: 2023 Tipo de documento: Article País de publicação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Choque Séptico / Sepse Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Aspecto: Patient_preference Limite: Child / Female / Humans / Infant / Male Idioma: En Revista: Pediatr Crit Care Med Assunto da revista: PEDIATRIA / TERAPIA INTENSIVA Ano de publicação: 2023 Tipo de documento: Article País de publicação: Estados Unidos