Prognostic value of extravascular lung water and its potential role in guiding fluid therapy in septic shock after initial resuscitation
Abstract Purposes To explore whether extravascular lung water (EVLW) provides a valuable prognostic tool guiding fluid therapy in septic shock patients after initial resuscitation. Materials and Methods We performed a retrospective study of septic shock patients who achieved adequate initial fluid r...
Gespeichert in:
| Veröffentlicht in: | Journal of critical care 2016-06, Vol.33, p.106-113 |
|---|---|
| Hauptverfasser: | , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 113 |
|---|---|
| container_issue | |
| container_start_page | 106 |
| container_title | Journal of critical care |
| container_volume | 33 |
| creator | Wang, Hao Cui, Na Su, Longxiang Long, Yun Wang, Xiaoting Zhou, Xiang Chai, Wenzhao Liu, Dawei |
| description | Abstract Purposes To explore whether extravascular lung water (EVLW) provides a valuable prognostic tool guiding fluid therapy in septic shock patients after initial resuscitation. Materials and Methods We performed a retrospective study of septic shock patients who achieved adequate initial fluid resuscitation with extended hemodynamic monitoring, analyzing the prognostic value of EVLW and whether fluid therapy for 24 (T24 ) or24-48 hours (T 24 -48 ) after initial resuscitation with a recommended value of EVLW yielded a 28-day mortality advantage. Results One hundred and five patients with septic shock were included in this study, sixty of whom (57.1%) died after 28 days. For 48 hours after initial resuscitation, the daily fluid balance (DFB)(T24 :2494±1091 vs.1965±964 mL, p=0.011 , andT 24 -48 : 2127±783vs.1588±665 mL, p |
| doi_str_mv | 10.1016/j.jcrc.2016.02.011 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1784462622</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0883944116000691</els_id><sourcerecordid>4037261131</sourcerecordid><originalsourceid>FETCH-LOGICAL-c505t-94f501eb1676a0e80efb4242a6a6ed26841d31fa9430b2dc79aacf6d3ccd25723</originalsourceid><addsrcrecordid>eNp9ks2KFDEUhQtRnHb0BVxIwI2bLpNUVaoKRBgG_2BAQV2H28mtntSkkzZJtfYb-Ngm9qgwC1cJ5DuH3HNuVT1ltGaUiZdzPaugap7vNeU1ZexetWJd168Hwbr71YoOQ7Me25adVY9inCllfdN0D6sz3lPOho6vqp-fgt86H5NR5AB2QeIngj9SgANEtVgIxC5uS75DwkDAaWJSJHuf0CUDlgRvkRhHtovRJnOTzReSrjHA_lgeIu6Ld7z26obAVFyMMyctxiUqkyAZ7x5XDyawEZ_cnufV17dvvly-X199fPfh8uJqrTrapTzN1FGGGyZ6ARQHitOm5S0HAQI1F0PLdMMmGNuGbrhW_QigJqEbpTTvet6cVy9Ovvvgvy0Yk9yZqNBacOiXKFk_tK3gghf0-R109ktw-Xe_qZLlMGaKnygVfIwBJ7kPZgfhKBmVpSc5y9KTLD1JymXuKYue3Vovmx3qv5I_xWTg1QnAnMXBYJA5KXQKtQmoktTe_N__9R25sjl2BfYGjxj_zSFjFsjPZVPKojBBKRUja34BSW-7JA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1784733589</pqid></control><display><type>article</type><title>Prognostic value of extravascular lung water and its potential role in guiding fluid therapy in septic shock after initial resuscitation</title><source>MEDLINE</source><source>Access via ScienceDirect (Elsevier)</source><source>ProQuest Central UK/Ireland</source><creator>Wang, Hao ; Cui, Na ; Su, Longxiang ; Long, Yun ; Wang, Xiaoting ; Zhou, Xiang ; Chai, Wenzhao ; Liu, Dawei</creator><creatorcontrib>Wang, Hao ; Cui, Na ; Su, Longxiang ; Long, Yun ; Wang, Xiaoting ; Zhou, Xiang ; Chai, Wenzhao ; Liu, Dawei</creatorcontrib><description><![CDATA[Abstract Purposes To explore whether extravascular lung water (EVLW) provides a valuable prognostic tool guiding fluid therapy in septic shock patients after initial resuscitation. Materials and Methods We performed a retrospective study of septic shock patients who achieved adequate initial fluid resuscitation with extended hemodynamic monitoring, analyzing the prognostic value of EVLW and whether fluid therapy for 24 (T24 ) or24-48 hours (T 24 -48 ) after initial resuscitation with a recommended value of EVLW yielded a 28-day mortality advantage. Results One hundred and five patients with septic shock were included in this study, sixty of whom (57.1%) died after 28 days. For 48 hours after initial resuscitation, the daily fluid balance (DFB)(T24 :2494±1091 vs.1965±964 mL, p=0.011 , andT 24 -48 : 2127±783vs.1588±665 mL, p<0.001 ) and daily maximum values of the extravascular lung water index (EVLWImax )(T24 :13.9±3.7 vs.11.5±3.2 mL/kg, p<0.001 , andT 24 -48 : 14.4±5.3vs. 12.0±4.4 mL/kg, p<0.001 ) were significantly higher in non-survivors than in survivors. In multivariate regression analysis, the DFB (T24 : odds ratio (OR) 1.001, p=0.016 , and T 24 -48 : OR 1.001, p=0.008 ), EVLWImax (T24 : OR 2.158, p=0.002 , and T 24 -48 : OR 3.277, p=0.001 ), blood lactate(T24 : OR 1.368, p=0.021, and T 24 -48 : OR 4.112, p<0.001 ), and ScvO2 (T24 : OR 0.893, p=0.013 , and T 24 -48 : OR 0.780, p=0.004 ) were all independently associated with the 28-day mortality. A receiver operating characteristic (ROC) analysis revealed that area under the curve (AUC) values of 0.82 (95% CI 0.74-0.91, p<0.001 ) and 0.90 (95% CI 0.83-0.96, p<0.001 ) forEVLWImax ≥ 12.5 mL/kg (T24 and T 24 -48 ) predicted a 28-day mortality with sensitivities of 88% (80-96) % and 95% (90-100) % and specificities of 60% (46-74) % and 76% (63-89) %.The EVLWImax was correlated with DFB with Spearman’s rho values of 0.497(T24 : p<0.001 ) and 0.650 (T 24 -48 : p<0.001 ). Cox survival and regression analyses demonstrated that EVLWImax ≥ 12.5 mL/kg(T24 and T 24 -48 ) was associated with higher risk and increased mortality, with adjusted odds ratios of 4.77 ( p<0.001 ) and 10.86 ( p<0.001 ). Conclusions A higher EVLW in septic shock patients after initial resuscitation was associated with a more positive fluid balance and increased mortality, which is an independent predictor of the 28-day mortality in septic shock patients after initial resuscitation.]]></description><identifier>ISSN: 0883-9441</identifier><identifier>EISSN: 1557-8615</identifier><identifier>DOI: 10.1016/j.jcrc.2016.02.011</identifier><identifier>PMID: 27021852</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adult ; Aged ; APACHE ; Blood pressure ; China ; Critical Care ; Extravascular Lung Water ; Female ; Fluid Therapy ; Fluids ; Hospitalization ; Humans ; Male ; Mortality ; Multivariate analysis ; Oximetry ; Permeability ; Prognosis ; Respiratory distress syndrome ; Resuscitation ; Retrospective Studies ; ROC Curve ; Sensitivity and Specificity ; Sepsis ; Septic shock ; Shock, Septic - mortality ; Shock, Septic - therapy ; Survival Analysis ; Transpulmonary thermodilution ; Ventilation ; Water-Electrolyte Balance</subject><ispartof>Journal of critical care, 2016-06, Vol.33, p.106-113</ispartof><rights>2016 Elsevier Inc.</rights><rights>Copyright © 2016 Elsevier Inc. All rights reserved.</rights><rights>2016. Elsevier Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c505t-94f501eb1676a0e80efb4242a6a6ed26841d31fa9430b2dc79aacf6d3ccd25723</citedby><cites>FETCH-LOGICAL-c505t-94f501eb1676a0e80efb4242a6a6ed26841d31fa9430b2dc79aacf6d3ccd25723</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/1784733589?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>315,781,785,3551,27928,27929,45999,64389,64391,64393,72473</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27021852$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wang, Hao</creatorcontrib><creatorcontrib>Cui, Na</creatorcontrib><creatorcontrib>Su, Longxiang</creatorcontrib><creatorcontrib>Long, Yun</creatorcontrib><creatorcontrib>Wang, Xiaoting</creatorcontrib><creatorcontrib>Zhou, Xiang</creatorcontrib><creatorcontrib>Chai, Wenzhao</creatorcontrib><creatorcontrib>Liu, Dawei</creatorcontrib><title>Prognostic value of extravascular lung water and its potential role in guiding fluid therapy in septic shock after initial resuscitation</title><title>Journal of critical care</title><addtitle>J Crit Care</addtitle><description><![CDATA[Abstract Purposes To explore whether extravascular lung water (EVLW) provides a valuable prognostic tool guiding fluid therapy in septic shock patients after initial resuscitation. Materials and Methods We performed a retrospective study of septic shock patients who achieved adequate initial fluid resuscitation with extended hemodynamic monitoring, analyzing the prognostic value of EVLW and whether fluid therapy for 24 (T24 ) or24-48 hours (T 24 -48 ) after initial resuscitation with a recommended value of EVLW yielded a 28-day mortality advantage. Results One hundred and five patients with septic shock were included in this study, sixty of whom (57.1%) died after 28 days. For 48 hours after initial resuscitation, the daily fluid balance (DFB)(T24 :2494±1091 vs.1965±964 mL, p=0.011 , andT 24 -48 : 2127±783vs.1588±665 mL, p<0.001 ) and daily maximum values of the extravascular lung water index (EVLWImax )(T24 :13.9±3.7 vs.11.5±3.2 mL/kg, p<0.001 , andT 24 -48 : 14.4±5.3vs. 12.0±4.4 mL/kg, p<0.001 ) were significantly higher in non-survivors than in survivors. In multivariate regression analysis, the DFB (T24 : odds ratio (OR) 1.001, p=0.016 , and T 24 -48 : OR 1.001, p=0.008 ), EVLWImax (T24 : OR 2.158, p=0.002 , and T 24 -48 : OR 3.277, p=0.001 ), blood lactate(T24 : OR 1.368, p=0.021, and T 24 -48 : OR 4.112, p<0.001 ), and ScvO2 (T24 : OR 0.893, p=0.013 , and T 24 -48 : OR 0.780, p=0.004 ) were all independently associated with the 28-day mortality. A receiver operating characteristic (ROC) analysis revealed that area under the curve (AUC) values of 0.82 (95% CI 0.74-0.91, p<0.001 ) and 0.90 (95% CI 0.83-0.96, p<0.001 ) forEVLWImax ≥ 12.5 mL/kg (T24 and T 24 -48 ) predicted a 28-day mortality with sensitivities of 88% (80-96) % and 95% (90-100) % and specificities of 60% (46-74) % and 76% (63-89) %.The EVLWImax was correlated with DFB with Spearman’s rho values of 0.497(T24 : p<0.001 ) and 0.650 (T 24 -48 : p<0.001 ). Cox survival and regression analyses demonstrated that EVLWImax ≥ 12.5 mL/kg(T24 and T 24 -48 ) was associated with higher risk and increased mortality, with adjusted odds ratios of 4.77 ( p<0.001 ) and 10.86 ( p<0.001 ). Conclusions A higher EVLW in septic shock patients after initial resuscitation was associated with a more positive fluid balance and increased mortality, which is an independent predictor of the 28-day mortality in septic shock patients after initial resuscitation.]]></description><subject>Adult</subject><subject>Aged</subject><subject>APACHE</subject><subject>Blood pressure</subject><subject>China</subject><subject>Critical Care</subject><subject>Extravascular Lung Water</subject><subject>Female</subject><subject>Fluid Therapy</subject><subject>Fluids</subject><subject>Hospitalization</subject><subject>Humans</subject><subject>Male</subject><subject>Mortality</subject><subject>Multivariate analysis</subject><subject>Oximetry</subject><subject>Permeability</subject><subject>Prognosis</subject><subject>Respiratory distress syndrome</subject><subject>Resuscitation</subject><subject>Retrospective Studies</subject><subject>ROC Curve</subject><subject>Sensitivity and Specificity</subject><subject>Sepsis</subject><subject>Septic shock</subject><subject>Shock, Septic - mortality</subject><subject>Shock, Septic - therapy</subject><subject>Survival Analysis</subject><subject>Transpulmonary thermodilution</subject><subject>Ventilation</subject><subject>Water-Electrolyte Balance</subject><issn>0883-9441</issn><issn>1557-8615</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp9ks2KFDEUhQtRnHb0BVxIwI2bLpNUVaoKRBgG_2BAQV2H28mtntSkkzZJtfYb-Ngm9qgwC1cJ5DuH3HNuVT1ltGaUiZdzPaugap7vNeU1ZexetWJd168Hwbr71YoOQ7Me25adVY9inCllfdN0D6sz3lPOho6vqp-fgt86H5NR5AB2QeIngj9SgANEtVgIxC5uS75DwkDAaWJSJHuf0CUDlgRvkRhHtovRJnOTzReSrjHA_lgeIu6Ld7z26obAVFyMMyctxiUqkyAZ7x5XDyawEZ_cnufV17dvvly-X199fPfh8uJqrTrapTzN1FGGGyZ6ARQHitOm5S0HAQI1F0PLdMMmGNuGbrhW_QigJqEbpTTvet6cVy9Ovvvgvy0Yk9yZqNBacOiXKFk_tK3gghf0-R109ktw-Xe_qZLlMGaKnygVfIwBJ7kPZgfhKBmVpSc5y9KTLD1JymXuKYue3Vovmx3qv5I_xWTg1QnAnMXBYJA5KXQKtQmoktTe_N__9R25sjl2BfYGjxj_zSFjFsjPZVPKojBBKRUja34BSW-7JA</recordid><startdate>20160601</startdate><enddate>20160601</enddate><creator>Wang, Hao</creator><creator>Cui, Na</creator><creator>Su, Longxiang</creator><creator>Long, Yun</creator><creator>Wang, Xiaoting</creator><creator>Zhou, Xiang</creator><creator>Chai, Wenzhao</creator><creator>Liu, Dawei</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AN0</scope><scope>ASE</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FPQ</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K6X</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20160601</creationdate><title>Prognostic value of extravascular lung water and its potential role in guiding fluid therapy in septic shock after initial resuscitation</title><author>Wang, Hao ; Cui, Na ; Su, Longxiang ; Long, Yun ; Wang, Xiaoting ; Zhou, Xiang ; Chai, Wenzhao ; Liu, Dawei</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c505t-94f501eb1676a0e80efb4242a6a6ed26841d31fa9430b2dc79aacf6d3ccd25723</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adult</topic><topic>Aged</topic><topic>APACHE</topic><topic>Blood pressure</topic><topic>China</topic><topic>Critical Care</topic><topic>Extravascular Lung Water</topic><topic>Female</topic><topic>Fluid Therapy</topic><topic>Fluids</topic><topic>Hospitalization</topic><topic>Humans</topic><topic>Male</topic><topic>Mortality</topic><topic>Multivariate analysis</topic><topic>Oximetry</topic><topic>Permeability</topic><topic>Prognosis</topic><topic>Respiratory distress syndrome</topic><topic>Resuscitation</topic><topic>Retrospective Studies</topic><topic>ROC Curve</topic><topic>Sensitivity and Specificity</topic><topic>Sepsis</topic><topic>Septic shock</topic><topic>Shock, Septic - mortality</topic><topic>Shock, Septic - therapy</topic><topic>Survival Analysis</topic><topic>Transpulmonary thermodilution</topic><topic>Ventilation</topic><topic>Water-Electrolyte Balance</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wang, Hao</creatorcontrib><creatorcontrib>Cui, Na</creatorcontrib><creatorcontrib>Su, Longxiang</creatorcontrib><creatorcontrib>Long, Yun</creatorcontrib><creatorcontrib>Wang, Xiaoting</creatorcontrib><creatorcontrib>Zhou, Xiang</creatorcontrib><creatorcontrib>Chai, Wenzhao</creatorcontrib><creatorcontrib>Liu, Dawei</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>British Nursing Database</collection><collection>British Nursing Index</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>British Nursing Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of critical care</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wang, Hao</au><au>Cui, Na</au><au>Su, Longxiang</au><au>Long, Yun</au><au>Wang, Xiaoting</au><au>Zhou, Xiang</au><au>Chai, Wenzhao</au><au>Liu, Dawei</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prognostic value of extravascular lung water and its potential role in guiding fluid therapy in septic shock after initial resuscitation</atitle><jtitle>Journal of critical care</jtitle><addtitle>J Crit Care</addtitle><date>2016-06-01</date><risdate>2016</risdate><volume>33</volume><spage>106</spage><epage>113</epage><pages>106-113</pages><issn>0883-9441</issn><eissn>1557-8615</eissn><abstract><![CDATA[Abstract Purposes To explore whether extravascular lung water (EVLW) provides a valuable prognostic tool guiding fluid therapy in septic shock patients after initial resuscitation. Materials and Methods We performed a retrospective study of septic shock patients who achieved adequate initial fluid resuscitation with extended hemodynamic monitoring, analyzing the prognostic value of EVLW and whether fluid therapy for 24 (T24 ) or24-48 hours (T 24 -48 ) after initial resuscitation with a recommended value of EVLW yielded a 28-day mortality advantage. Results One hundred and five patients with septic shock were included in this study, sixty of whom (57.1%) died after 28 days. For 48 hours after initial resuscitation, the daily fluid balance (DFB)(T24 :2494±1091 vs.1965±964 mL, p=0.011 , andT 24 -48 : 2127±783vs.1588±665 mL, p<0.001 ) and daily maximum values of the extravascular lung water index (EVLWImax )(T24 :13.9±3.7 vs.11.5±3.2 mL/kg, p<0.001 , andT 24 -48 : 14.4±5.3vs. 12.0±4.4 mL/kg, p<0.001 ) were significantly higher in non-survivors than in survivors. In multivariate regression analysis, the DFB (T24 : odds ratio (OR) 1.001, p=0.016 , and T 24 -48 : OR 1.001, p=0.008 ), EVLWImax (T24 : OR 2.158, p=0.002 , and T 24 -48 : OR 3.277, p=0.001 ), blood lactate(T24 : OR 1.368, p=0.021, and T 24 -48 : OR 4.112, p<0.001 ), and ScvO2 (T24 : OR 0.893, p=0.013 , and T 24 -48 : OR 0.780, p=0.004 ) were all independently associated with the 28-day mortality. A receiver operating characteristic (ROC) analysis revealed that area under the curve (AUC) values of 0.82 (95% CI 0.74-0.91, p<0.001 ) and 0.90 (95% CI 0.83-0.96, p<0.001 ) forEVLWImax ≥ 12.5 mL/kg (T24 and T 24 -48 ) predicted a 28-day mortality with sensitivities of 88% (80-96) % and 95% (90-100) % and specificities of 60% (46-74) % and 76% (63-89) %.The EVLWImax was correlated with DFB with Spearman’s rho values of 0.497(T24 : p<0.001 ) and 0.650 (T 24 -48 : p<0.001 ). Cox survival and regression analyses demonstrated that EVLWImax ≥ 12.5 mL/kg(T24 and T 24 -48 ) was associated with higher risk and increased mortality, with adjusted odds ratios of 4.77 ( p<0.001 ) and 10.86 ( p<0.001 ). Conclusions A higher EVLW in septic shock patients after initial resuscitation was associated with a more positive fluid balance and increased mortality, which is an independent predictor of the 28-day mortality in septic shock patients after initial resuscitation.]]></abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>27021852</pmid><doi>10.1016/j.jcrc.2016.02.011</doi><tpages>8</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0883-9441 |
| ispartof | Journal of critical care, 2016-06, Vol.33, p.106-113 |
| issn | 0883-9441 1557-8615 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1784462622 |
| source | MEDLINE; Access via ScienceDirect (Elsevier); ProQuest Central UK/Ireland |
| subjects | Adult Aged APACHE Blood pressure China Critical Care Extravascular Lung Water Female Fluid Therapy Fluids Hospitalization Humans Male Mortality Multivariate analysis Oximetry Permeability Prognosis Respiratory distress syndrome Resuscitation Retrospective Studies ROC Curve Sensitivity and Specificity Sepsis Septic shock Shock, Septic - mortality Shock, Septic - therapy Survival Analysis Transpulmonary thermodilution Ventilation Water-Electrolyte Balance |
| title | Prognostic value of extravascular lung water and its potential role in guiding fluid therapy in septic shock after initial resuscitation |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-16T13%3A54%3A48IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Prognostic%20value%20of%20extravascular%20lung%20water%20and%20its%20potential%20role%20in%20guiding%20fluid%20therapy%20in%20septic%20shock%20after%20initial%20resuscitation&rft.jtitle=Journal%20of%20critical%20care&rft.au=Wang,%20Hao&rft.date=2016-06-01&rft.volume=33&rft.spage=106&rft.epage=113&rft.pages=106-113&rft.issn=0883-9441&rft.eissn=1557-8615&rft_id=info:doi/10.1016/j.jcrc.2016.02.011&rft_dat=%3Cproquest_cross%3E4037261131%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1784733589&rft_id=info:pmid/27021852&rft_els_id=S0883944116000691&rfr_iscdi=true |