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Fluid Overload in Children with Severe Sepsis and Septic Shock

Received: 17 October 2019     Accepted: 20 December 2019     Published: 31 December 2019
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Abstract

Fluid therapy is one pillar of the treatment of septic shock, however, a hydric≥10% of the weight or Fluid Overload (FO>10%) is associated with poor hospital outcomes. The present study aims to determine the FO in patients with septic shock, and its main associations in terms of mortality and morbidity. An observational and descriptive study was conducted in 49 hospitalized children with septic shock in the PICU of the Manuel Ascencio Villarroel Children’s Hospital (MAVCH); The patients were divided into two groups according to the FO>10% (22 patients) and<10% (18 patients), for their descriptive analysis we included comparison of means and calculation of the OR. Regarding the water requirements, we observed that the group with FO>10% a mean of 5681ml; while in the group with ISCH<10% the mean was 3297.8ml (p=0.19) during first 72 hours, showing greater overload with the administration of colloids and blood products (p=0.02, p=0.004). Regarding hospital outcomes, was found morbidity associated with FO>10% (respiratory dysfunction, vasopressor requirement and renal replacement therapy); The length of hospitalization and FO were not different in groups (p=0.60), but there was higher mortality of patients with FO>10% (p=0.01, OR: 5.57 IC95% 1.4-21.8). Fluids therapy of in the patient with septic shock constitutes one of the first-line hemodynamic treatments, however in limited resources settings, overload should be avoided, mainly due to associated morbidity during the first 72 hours.

Published in American Journal of Pediatrics (Volume 5, Issue 4)
DOI 10.11648/j.ajp.20190504.33
Page(s) 299-303
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2019. Published by Science Publishing Group

Keywords

Fluid Overload, Sepsis, Septic Shock, Fluid Therapy

References
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Cite This Article
  • APA Style

    Copana Raul, Diaz Willmer. (2019). Fluid Overload in Children with Severe Sepsis and Septic Shock. American Journal of Pediatrics, 5(4), 299-303. https://doi.org/10.11648/j.ajp.20190504.33

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    ACS Style

    Copana Raul; Diaz Willmer. Fluid Overload in Children with Severe Sepsis and Septic Shock. Am. J. Pediatr. 2019, 5(4), 299-303. doi: 10.11648/j.ajp.20190504.33

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    AMA Style

    Copana Raul, Diaz Willmer. Fluid Overload in Children with Severe Sepsis and Septic Shock. Am J Pediatr. 2019;5(4):299-303. doi: 10.11648/j.ajp.20190504.33

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  • @article{10.11648/j.ajp.20190504.33,
      author = {Copana Raul and Diaz Willmer},
      title = {Fluid Overload in Children with Severe Sepsis and Septic Shock},
      journal = {American Journal of Pediatrics},
      volume = {5},
      number = {4},
      pages = {299-303},
      doi = {10.11648/j.ajp.20190504.33},
      url = {https://doi.org/10.11648/j.ajp.20190504.33},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajp.20190504.33},
      abstract = {Fluid therapy is one pillar of the treatment of septic shock, however, a hydric≥10% of the weight or Fluid Overload (FO>10%) is associated with poor hospital outcomes. The present study aims to determine the FO in patients with septic shock, and its main associations in terms of mortality and morbidity. An observational and descriptive study was conducted in 49 hospitalized children with septic shock in the PICU of the Manuel Ascencio Villarroel Children’s Hospital (MAVCH); The patients were divided into two groups according to the FO>10% (22 patients) and10% a mean of 5681ml; while in the group with ISCH10% (respiratory dysfunction, vasopressor requirement and renal replacement therapy); The length of hospitalization and FO were not different in groups (p=0.60), but there was higher mortality of patients with FO>10% (p=0.01, OR: 5.57 IC95% 1.4-21.8). Fluids therapy of in the patient with septic shock constitutes one of the first-line hemodynamic treatments, however in limited resources settings, overload should be avoided, mainly due to associated morbidity during the first 72 hours.},
     year = {2019}
    }
    

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    AU  - Copana Raul
    AU  - Diaz Willmer
    Y1  - 2019/12/31
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    DO  - 10.11648/j.ajp.20190504.33
    T2  - American Journal of Pediatrics
    JF  - American Journal of Pediatrics
    JO  - American Journal of Pediatrics
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    PB  - Science Publishing Group
    SN  - 2472-0909
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    AB  - Fluid therapy is one pillar of the treatment of septic shock, however, a hydric≥10% of the weight or Fluid Overload (FO>10%) is associated with poor hospital outcomes. The present study aims to determine the FO in patients with septic shock, and its main associations in terms of mortality and morbidity. An observational and descriptive study was conducted in 49 hospitalized children with septic shock in the PICU of the Manuel Ascencio Villarroel Children’s Hospital (MAVCH); The patients were divided into two groups according to the FO>10% (22 patients) and10% a mean of 5681ml; while in the group with ISCH10% (respiratory dysfunction, vasopressor requirement and renal replacement therapy); The length of hospitalization and FO were not different in groups (p=0.60), but there was higher mortality of patients with FO>10% (p=0.01, OR: 5.57 IC95% 1.4-21.8). Fluids therapy of in the patient with septic shock constitutes one of the first-line hemodynamic treatments, however in limited resources settings, overload should be avoided, mainly due to associated morbidity during the first 72 hours.
    VL  - 5
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Author Information
  • Pediatric Intensive Care Department, Manuel Ascencio Villarroel Children′s Hospital, Cochabamba, Bolivia

  • Pediatric Intensive Care Department, Ovidio Aliaga Uria Chidren′s Hospital, La Paz, Bolivia

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