TY - JOUR
T1 - Postoperative fluid overload
T2 - Not a benign problem
AU - Lowell, J. A.
AU - Schifferdecker, C.
AU - Driscoll, D. F.
AU - Benotti, P. N.
AU - Bistrian, B. R.
PY - 1990
Y1 - 1990
N2 - The incidence and consequences of fluid overload in the surgical ICU (SICU) have not been well defined, but may influence length of stay, days requiring mechanical ventilation, and mortality. Forty-eight consecutive patients admitted to our SICU were prospectively monitored for acute changes in weight and its impact on clinical management and outcome. When defined as a gain >10% from their preoperative or premorbid weight (or an approximately 20% increase in total body water), 40% of patients had fluid overload. Patients were divided into three groups: those who had gained ≤10%, those with a weight gain between 11% and 20%, and those with >20% increase in weight. Significant differences were found with respect to vasopressor dependence, colloid administration, and mortality. When indexed by initial Acute Physiology and Chronic Health Evaluation (APACHE II) mortality prediction scores, all groups had similar degrees of illness. On average, presumably due to volume limitations, patients were inadequately nourished during 85% of their SICU stay. Our results suggest that the morbidity of fluid overload can be significant, and warrants a fresh look at the methods of intraoperative fluid resuscitation.
AB - The incidence and consequences of fluid overload in the surgical ICU (SICU) have not been well defined, but may influence length of stay, days requiring mechanical ventilation, and mortality. Forty-eight consecutive patients admitted to our SICU were prospectively monitored for acute changes in weight and its impact on clinical management and outcome. When defined as a gain >10% from their preoperative or premorbid weight (or an approximately 20% increase in total body water), 40% of patients had fluid overload. Patients were divided into three groups: those who had gained ≤10%, those with a weight gain between 11% and 20%, and those with >20% increase in weight. Significant differences were found with respect to vasopressor dependence, colloid administration, and mortality. When indexed by initial Acute Physiology and Chronic Health Evaluation (APACHE II) mortality prediction scores, all groups had similar degrees of illness. On average, presumably due to volume limitations, patients were inadequately nourished during 85% of their SICU stay. Our results suggest that the morbidity of fluid overload can be significant, and warrants a fresh look at the methods of intraoperative fluid resuscitation.
UR - http://www.scopus.com/inward/record.url?scp=0025350488&partnerID=8YFLogxK
U2 - 10.1097/00003246-199007000-00010
DO - 10.1097/00003246-199007000-00010
M3 - Article
C2 - 2364713
AN - SCOPUS:0025350488
SN - 0090-3493
VL - 18
SP - 728
EP - 733
JO - Critical care medicine
JF - Critical care medicine
IS - 7
ER -