Fluid overload (FO) is common in general pediatric intensive care unit (PICU). Information on impact of FO on oxygenation and mortality in ventilated pediatric patients is limited
To prospectively evaluate the association between FO and oxygenation, mortality, mechanical ventilation (MV) duration, and length of stay in a PICU.
From January to August 2018, 245 children aged ≤ 36 months, who were on invasive MV for > 24 h at the PICU of Vietnam National Children's Hospital were included. Demographic and clinical data were recorded. Daily FO was calculated as [(fluid in-fluid out)/admission weight] × 100% in the first 7 days following admission. Univariate and multivariate analysis were used to assess the independent association between FO percent and oxygenation and clinical outcomes.
Median age was 5.5 (IQR 3, 11) months. Peak FO ≥ 10% was present in 20.0%, and FO>15% was present in 9.0% of patients. Peak FO% during the study period correlated significantly with oxygenation index (OI) (r = 0.23, p =.03). Mortality was 29.0%. Fluid overload ≥ 10% was associated with an increased risk of mortality (OR = 3.1, 95% CI 1.5- 6.5, p=.002) after adjusting for age, PELOD score, and disease severity. We observed a dose-response relationship between FO and mortality, as the FO % cutoff percentage increased, odd ratio for mortality significantly increased. FO was associated with MV duration but not with PICU length of stay.
FO was associated with impaired oxygenation, increased risk of mortality, and prolonged duration of MV among survivors in mechanically ventilated children.