• Sukla Samaddar, Jhuma Sankar, Sushil Kumar Kabra, and Rakesh Lodha.
• Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India.
• Indian Pediatr. 2018 Nov 15; 55 (11): 957-961.

ObjectiveTo study the association of fluid overload with mortality and morbidity in critically-ill mechanically ventilated children.DesignProspective observational study.SettingPediatric Intensive Care Unit (PICU) of a tertiary care hospital, New Delhi, India.Participants118 children (age 1 mo - 15 y) requiring mechanical ventilation.Outcome MeasuresPrimary: Association of fluid overload with mortality. Secondary: Association of fluid overload with oxygenation, organ dysfunction, duration of mechanical ventilation and PICU stay.ResultsCumulative fluid overload of ≥15% was observed in 74 (62.7%) children. About 50% of these children reached cumulative fluid overload of ≥15% within the first 5 days of PICU stay. The mortality was 40.5% in those with ≥15% cumulative fluid compared to 34% in the rest [OR (95% CI): 1.02 (0.97, 1.07)]. On multivariate analysis, after adjusting for confounders, cumulative fluid overload ≥15% was associated with higher maximum PELOD (pediatric logistic organ dysfunction) score (Median: 21 vs. 12; P = 0.03), longer median duration of mechanical ventilation (10 vs. 4 d; P <0.0001) and PICU stay (13.5 vs. 6 d; P <0.0001). There was no significant association of fluid overload with oxygenation index (P=0.32).ConclusionsThere is no association of fluid overload with mortality. However, it is associated with poor organ function, longer duration of mechanical ventilation and PICU stay in critically-ill, mechanically ventilated children.

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