Fluid Status Assessment in Critically Ill Patients with COVID-19: A Retrospective Cohort Study
Fluid status (FS) is a diagnostic challenge in critically ill patients with COVID-19. Here, we compared parameters related to FS derived from cumulative fluid balance (CFB), bioelectrical impedance analysis (BIA) and venous congestion assessed by ultrasound (VExUS) to predict mortality. We retrospec...
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| Format: | Article |
| Language: | English |
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MDPI AG
2024-01-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/13/2/540 |
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| author | Nadia Rodríguez-Moguel Ivan Armando Osuna-Padilla Karolina Bozena Piekarska María-Fernanda Negrete-García Andrea Hernández-Muñoz Julián Andrés Contreras-Marín Roberto Montaño-Mattar Gustavo Casas-Aparicio |
| author_facet | Nadia Rodríguez-Moguel Ivan Armando Osuna-Padilla Karolina Bozena Piekarska María-Fernanda Negrete-García Andrea Hernández-Muñoz Julián Andrés Contreras-Marín Roberto Montaño-Mattar Gustavo Casas-Aparicio |
| author_sort | Nadia Rodríguez-Moguel |
| collection | DOAJ |
| description | Fluid status (FS) is a diagnostic challenge in critically ill patients with COVID-19. Here, we compared parameters related to FS derived from cumulative fluid balance (CFB), bioelectrical impedance analysis (BIA) and venous congestion assessed by ultrasound (VExUS) to predict mortality. We retrospectively reviewed the medical records of individuals with severe pneumonia due to COVID-19 between July and November 2021 in a single center. Comorbidities, demographic, clinical and laboratory data as well as results from CFB, BIA and VExUS measurements were collected on admission and weekly afterwards for two consecutive evaluations. Seventy-nine patients were included, of which eighteen (14.2%) died. Abnormalities of FS were only identified by BIA. Extracellular water/total body water ratio (ECW/TBW) > 0.394 (overhydrated) by BIA was a good predictor of mortality (AUC = 0.78, 95% CI: 0.067–0.89). Mortality risk was higher in overhydrated patients (OR: 6.2, 95% CI: 1.2–32.6, <i>p</i> = 0.02) and in persistently overhydrated patients (OR: 9.57, 95% CI: 1.18–77.5, <i>p</i> = 0.03) even after adjustment to age, serum albumin and acute kidney injury (AKI) in stages 2–3. Time to death was shorter in overhydrated patients (HR: 2.82, 95% CI: 1.05–7.5, log-rank test <i>p</i> = 0.03). Abnormalities in FS associated with mortality were only identified by BIA in critically ill patients with COVID-19. |
| first_indexed | 2024-03-08T09:51:37Z |
| format | Article |
| id | doaj.art-17b9d10d2f8c4c81b359dc83133c70a1 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-08T09:51:37Z |
| publishDate | 2024-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-17b9d10d2f8c4c81b359dc83133c70a12024-01-29T14:02:49ZengMDPI AGJournal of Clinical Medicine2077-03832024-01-0113254010.3390/jcm13020540Fluid Status Assessment in Critically Ill Patients with COVID-19: A Retrospective Cohort StudyNadia Rodríguez-Moguel0Ivan Armando Osuna-Padilla1Karolina Bozena Piekarska2María-Fernanda Negrete-García3Andrea Hernández-Muñoz4Julián Andrés Contreras-Marín5Roberto Montaño-Mattar6Gustavo Casas-Aparicio7Departamento de Investigación en Enfermedades Infecciosas, Instituto Nacional de Enfermedades Respiratorias “Ismael Cosío Villegas”, Mexico City 14080, MexicoDepartamento de Áreas Críticas, Instituto Nacional de Enfermedades Respiratorias “Ismael Cosío Villegas”, Mexico City 14080, MexicoDepartamento de Enseñanza, Instituto Nacional de Enfermedades Respiratorias “Ismael Cosío Villegas”, Mexico City 14080, MexicoDepartamento de Enseñanza, Instituto Nacional de Enfermedades Respiratorias “Ismael Cosío Villegas”, Mexico City 14080, MexicoFacultad de Nutrición, Universidad Autónoma del Estado de Morelos, Cuernavaca 62209, MexicoDepartamento de Enseñanza, Instituto Nacional de Enfermedades Respiratorias “Ismael Cosío Villegas”, Mexico City 14080, MexicoDepartamento de Enseñanza, Instituto Nacional de Enfermedades Respiratorias “Ismael Cosío Villegas”, Mexico City 14080, MexicoDepartamento de Nefrología, Instituto Nacional de Enfermedades Respiratorias “Ismael Cosío Villegas”, Mexico City 14080, MexicoFluid status (FS) is a diagnostic challenge in critically ill patients with COVID-19. Here, we compared parameters related to FS derived from cumulative fluid balance (CFB), bioelectrical impedance analysis (BIA) and venous congestion assessed by ultrasound (VExUS) to predict mortality. We retrospectively reviewed the medical records of individuals with severe pneumonia due to COVID-19 between July and November 2021 in a single center. Comorbidities, demographic, clinical and laboratory data as well as results from CFB, BIA and VExUS measurements were collected on admission and weekly afterwards for two consecutive evaluations. Seventy-nine patients were included, of which eighteen (14.2%) died. Abnormalities of FS were only identified by BIA. Extracellular water/total body water ratio (ECW/TBW) > 0.394 (overhydrated) by BIA was a good predictor of mortality (AUC = 0.78, 95% CI: 0.067–0.89). Mortality risk was higher in overhydrated patients (OR: 6.2, 95% CI: 1.2–32.6, <i>p</i> = 0.02) and in persistently overhydrated patients (OR: 9.57, 95% CI: 1.18–77.5, <i>p</i> = 0.03) even after adjustment to age, serum albumin and acute kidney injury (AKI) in stages 2–3. Time to death was shorter in overhydrated patients (HR: 2.82, 95% CI: 1.05–7.5, log-rank test <i>p</i> = 0.03). Abnormalities in FS associated with mortality were only identified by BIA in critically ill patients with COVID-19.https://www.mdpi.com/2077-0383/13/2/540fluid overloadcritically illCOVID-19 |
| spellingShingle | Nadia Rodríguez-Moguel Ivan Armando Osuna-Padilla Karolina Bozena Piekarska María-Fernanda Negrete-García Andrea Hernández-Muñoz Julián Andrés Contreras-Marín Roberto Montaño-Mattar Gustavo Casas-Aparicio Fluid Status Assessment in Critically Ill Patients with COVID-19: A Retrospective Cohort Study Journal of Clinical Medicine fluid overload critically ill COVID-19 |
| title | Fluid Status Assessment in Critically Ill Patients with COVID-19: A Retrospective Cohort Study |
| title_full | Fluid Status Assessment in Critically Ill Patients with COVID-19: A Retrospective Cohort Study |
| title_fullStr | Fluid Status Assessment in Critically Ill Patients with COVID-19: A Retrospective Cohort Study |
| title_full_unstemmed | Fluid Status Assessment in Critically Ill Patients with COVID-19: A Retrospective Cohort Study |
| title_short | Fluid Status Assessment in Critically Ill Patients with COVID-19: A Retrospective Cohort Study |
| title_sort | fluid status assessment in critically ill patients with covid 19 a retrospective cohort study |
| topic | fluid overload critically ill COVID-19 |
| url | https://www.mdpi.com/2077-0383/13/2/540 |
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