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A past medical history of heart failure is associated with less fluid therapy in septic patients. | LitMetric

AI Article Synopsis

  • The study examined factors influencing fluid resuscitation in 181 septic patients admitted to an ICU from 2012 to 2016.
  • A history of heart failure was linked to receiving significantly less IV fluids (1L less) during the first 24 hours, but overall fluid volume didn't affect mortality rates.
  • No other cardiac conditions, like left ventricular function or hypertension, impacted fluid therapy in these patients.

Article Abstract

Objective: To identify the underlying factors that affect fluid resuscitation in septic patients.

Methods: The present study was a case-control study of 181 consecutive patients admitted to a Medical Intensive Care Unit between 2012 and 2016 with a diagnosis of sepsis. Demographic, clinical, radiological and laboratory data were analyzed.

Results: One hundred-thirty patients (72%) received ≥ 30mL/kg of IV fluids on admission. On univariate analyses, a past history of coronary artery disease and heart failure was associated with less fluid therapy. On multivariate analyses, a history of heart failure (OR = 2.31; 95%CI 1.04 - 5.14) remained significantly associated with receiving less IV fluids. Left ventricular ejection fraction, systolic/diastolic function, left ventricular hypertrophy and pulmonary hypertension were not associated with IV fluids. The amount of IV fluids was not associated with differences in mortality. During the first 24 hours, patients with a past history of heart failure received 2,900mLof IV fluids [1,688 - 4,714mL] versus 3,977mL [2,500 - 6,200mL] received by those without a history of heart failure, p = 0.02.

Conclusion: Septic patients with a past history of heart failure received 1L less IV fluids in the first 24 hours with no difference in mortality.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7005955PMC
http://dx.doi.org/10.5935/0103-507X.20190049DOI Listing

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