Effect of restrictive cumulative fluid balance on 28-day survival in invasively ventilated patients with moderate to severe ARDS due to COVID-19

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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorTREML, Ricardo Esper
dc.contributor.authorCALDONAZO, Tulio
dc.contributor.authorHILTON FILHO, Pedro A.
dc.contributor.authorMORI, Andreia L.
dc.contributor.authorCARVALHO, Andre S.
dc.contributor.authorSERRANO, Juliana S. F.
dc.contributor.authorDALL-AGLIO, Pedro A. T.
dc.contributor.authorRADERMACHER, Peter
dc.contributor.authorJR, Joao Silva Manoel
dc.date.accessioned2023-12-15T18:59:46Z
dc.date.available2023-12-15T18:59:46Z
dc.date.issued2023
dc.description.abstractThis study aimed to evaluate the effect of two restrictive cumulative fluid balance (CFB) trends on survival and on major clinical outcomes in invasively ventilated patients with moderate to severe respiratory distress syndrome (ARDS) due to SARS-CoV-2. Prospective data collection was conducted on patients in the intensive care unit (ICU) originating from a tertiary university hospital. The primary outcomes were the risk association between the CFB trend during D0 to D7 and 28-day survival. The secondary outcomes were ICU mortality, in-hospital mortality, the need for invasive ventilation at D28, administration of vasoactive drugs at D7, time on invasive ventilation after D7, and length of ICU and hospital stay. 171 patients were enrolled in the study and divided according to their CFB trends during seven days of follow-up using model-based clustering [median CFB negative trend (n = 89) - 279 ml (- 664 to 203) and (n = 82) median CFB positive trend 1362 ml (619-2026)]. The group with CFB negative trend showed a higher chance of surviving 28-day in the ICU (HR: 0.62, 95% CI 0.41-0.94, p = 0.038). Moreover, this group had a reduced length of stay in the ICU, 11 (8-19) days versus 16.5 (9-29) days p = 0.004 and presented lower rates (OR = 0.22; 95% CI 0.09-0.52) of invasive ventilation after 28-days in the ICU. In patients invasively ventilated with moderate to severe ARDS due to COVID-19, the collective who showed a negative trend in the CFB after seven days of invasive ventilation had a higher chance of surviving 28 days in the ICU and lower length of stay in the ICU.eng
dc.description.indexMEDLINE
dc.description.indexPubMed
dc.description.indexWoS
dc.description.indexScopus
dc.description.sponsorshipRicardo Esper Treml and Tulio Caldonazo are supported by the Clinical Scientist Program (Jena University Hospital). The authors thank all patients and healthcare personnel involved in the study.
dc.description.sponsorshipClinical Scientist Program (Jena University Hospital)
dc.identifier.citationSCIENTIFIC REPORTS, v.13, n.1, article ID 18504, 11p, 2023
dc.identifier.doi10.1038/s41598-023-45483-8
dc.identifier.issn2045-2322
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/57647
dc.language.isoeng
dc.publisherNATURE PORTFOLIOeng
dc.relation.ispartofScientific Reports
dc.rightsrestrictedAccesseng
dc.rights.holderCopyright NATURE PORTFOLIOeng
dc.subject.otherrespiratory-distress-syndromeeng
dc.subject.othergoodness-of-fiteng
dc.subject.otherseptic shockeng
dc.subject.othersepsiseng
dc.subject.othermanagementeng
dc.subject.otherresuscitationeng
dc.subject.otherepidemiologyeng
dc.subject.othersurgeryeng
dc.subject.otherriskeng
dc.subject.wosMultidisciplinary Scienceseng
dc.titleEffect of restrictive cumulative fluid balance on 28-day survival in invasively ventilated patients with moderate to severe ARDS due to COVID-19eng
dc.typearticleeng
dc.type.categoryoriginal articleeng
dc.type.versionpublishedVersioneng
dspace.entity.typePublication
hcfmusp.affiliation.countryAlemanha
hcfmusp.affiliation.countryisode
hcfmusp.author.externalTREML, Ricardo Esper:Friedrich Schiller Univ, Dept Anesthesiol & Intens Care Med, Jena, Germany; Univ Sao Paulo, Dept Anesthesiol, Postgrad Program, Ave Dr Arnaldo 455, BR-01246903 Sao Paulo, SP, Brazil
hcfmusp.author.externalCALDONAZO, Tulio:Friedrich Schiller Univ, Dept Cardiothorac Surg, Jena, Germany
hcfmusp.author.externalHILTON FILHO, Pedro A.:Servidor Publ Estadual Hosp, Dept Anesthesiol, Sao Paulo, Brazil
hcfmusp.author.externalMORI, Andreia L.:Servidor Publ Estadual Hosp, Dept Anesthesiol, Sao Paulo, Brazil
hcfmusp.author.externalCARVALHO, Andre S.:Servidor Publ Estadual Hosp, Dept Anesthesiol, Sao Paulo, Brazil
hcfmusp.author.externalSERRANO, Juliana S. F.:Servidor Publ Estadual Hosp, Dept Anesthesiol, Sao Paulo, Brazil
hcfmusp.author.externalRADERMACHER, Peter:Ulm Univ Hosp, Inst Anesthesiol Pathophysiol & Proc Dev, Ulm, Germany
hcfmusp.citation.scopus1
hcfmusp.contributor.author-fmusphcPEDRO AUGUSTO TAVARES DALL AGLIO
hcfmusp.contributor.author-fmusphcJOAO MANOEL DA SILVA JUNIOR
hcfmusp.description.articlenumber18504
hcfmusp.description.issue1
hcfmusp.description.volume13
hcfmusp.origemWOS
hcfmusp.origem.pubmed37898681
hcfmusp.origem.scopus2-s2.0-85175150089
hcfmusp.origem.wosWOS:001093350900013
hcfmusp.publisher.cityBERLINeng
hcfmusp.publisher.countryGERMANYeng
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Artigos e Materiais de Revistas Científicas - HC/ICESP
Artigos e Materiais de Revistas Científicas - COVID-19
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