Yanfei Shen1, Weimin Zhang2, Xuping Cheng2, Manzhen Ying2. 1. Department of Intensive Care Unit, Dongyang People's Hospital, No. 60, Wuning West Road, Dongyang, Jinhua, Zhejiang 322100, PR China. Electronic address: snow.shen@hotmail.com. 2. Department of Intensive Care Unit, Dongyang People's Hospital, No. 60, Wuning West Road, Dongyang, Jinhua, Zhejiang 322100, PR China.
Abstract
PURPOSE: The present study aims to explore appropriate postoperative fluid management in patients after cardiac surgery. MATERIALS AND METHODS: Data were extracted from an online database. Associations between fluid balance (FB), fluid intake and mortality were investigated. RESULTS: Compared to zero FB (level 3), more negative FB (level 1, odds ratio (OR): 0.938, 95% CI: 0.631-1.394; level 2, OR: 0.921, 95% CI: 0.709-1.196) could not further decrease AKI incidence while positive FB was associated with higher AKI incidence (level 4, OR: 1.272, 95% CI: 1.028-1.573; level 5, OR: 2.042, 95% CI: 1.652-2.524). Both limited (level 1, OR: 1.354, 95% CI: 1.065-1.699) and increased postoperative fluid intake (level 3, OR: 1.127, 95% CI: 0.890-1.430; to level 5, OR: 1.405, 95% CI: 1.105-1.786) were associated with increased AKI incidence, compared to level 2. Multivariable logistic models using linear spline function showed a similar pattern. CONCLUSIONS: Compared to zero FB, postoperative positive FB was associated with higher AKI incidence. Yet, the association between negative FB and AKI was insignificant. A "U"-shape association between postoperative fluid intake and AKI was detected.
PURPOSE: The present study aims to explore appropriate postoperative fluid management in patients after cardiac surgery. MATERIALS AND METHODS: Data were extracted from an online database. Associations between fluid balance (FB), fluid intake and mortality were investigated. RESULTS: Compared to zero FB (level 3), more negative FB (level 1, odds ratio (OR): 0.938, 95% CI: 0.631-1.394; level 2, OR: 0.921, 95% CI: 0.709-1.196) could not further decrease AKI incidence while positive FB was associated with higher AKI incidence (level 4, OR: 1.272, 95% CI: 1.028-1.573; level 5, OR: 2.042, 95% CI: 1.652-2.524). Both limited (level 1, OR: 1.354, 95% CI: 1.065-1.699) and increased postoperative fluid intake (level 3, OR: 1.127, 95% CI: 0.890-1.430; to level 5, OR: 1.405, 95% CI: 1.105-1.786) were associated with increased AKI incidence, compared to level 2. Multivariable logistic models using linear spline function showed a similar pattern. CONCLUSIONS: Compared to zero FB, postoperative positive FB was associated with higher AKI incidence. Yet, the association between negative FB and AKI was insignificant. A "U"-shape association between postoperative fluid intake and AKI was detected.
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