Fluid balance does not predict estimated sodium balance in critically ill mechanically ventilated patients

Date

2013

Authors

Bihari, S.
Baldwin, C.E.
Bersten, A.D.

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Journal article

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Critical Care and Resuscitation, 2013; 15(2):89-96

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Abstract

Background: Distribution of total body water (TBW) depends on local and systemic factors including osmolality, relative sodium content and permeability. Although positive fluid balance has been associated with increased morbidity and mortality in critically ill patients, the mechanisms and relative roles of sodium balance and water distribution are uncertain. Objective: To track changes in sodium and fluid balance, respiratory function and body composition in patients who required mechanical ventilation for 48 hours. Methods: Sodium and fluid balances were estimated daily for up to 5 days, following institution of mechanical ventilation on Day 0. Serum sodium level, oxygenation (PaO2/FIO2), body weight, intracellular and extracellular fluid (ECF) distribution (bioelectrical impedance spectroscopy), and blinded chest x-ray oedema scores were performed daily. Conclusions: Fluid balance may not reflect sodium balance in critically ill patients. As sodium balance correlates with respiratory dysfunction and increased extracellular volume, further studies examining sodium balance and morbidity seem warranted.

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Copyright 2013 College of Intensive Care Medicine of Australia and New Zealand. (http://creativecommons.org/licenses/by-nc-nd/4.0/) Access Condition Notes: Under a Creative Commons Licence.

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