• Galinos Barmparas, Douglas Liou, Debora Lee, Nicole Fierro, Matthew Bloom, Eric Ley, Ali Salim, and Marko Bukur.
• Department of Surgery, Division of Acute Care Surgery, Cedars-Sinai Medical Center, Los Angeles, CA.
• J Crit Care. 2014 Dec 1;29(6):936-41.

PurposeThe purpose of this study is to determine the effect of postoperative fluid balance (FB) on subsequent outcomes in acute care surgery (ACS) patients admitted to the surgical intensive care unit (ICU).Material And MethodsAcute care surgery patients admitted to the surgical ICU from 06/2012 to 01/2013 were followed up prospectively. Patients were stratified by FB into FB-positive (+) and FB-negative (-) groups by surgical ICU day 5 or day of discharge from the surgical ICU.ResultsA total of 144 ACS patients met inclusion criteria. Although there was no statistically significant difference in crude mortality (11% for FB [-] vs 15.5% for FB [+]; P=.422], after adjusting for confounding factors, achieving an FB (-) status by day 5 during the surgical ICU stay was associated with an almost 70% survival benefit (adjusted odds ratio [95% confidence interval], 0.31 [0.13, 0.76]; P=.010). In addition, achieving a fluid negative status by day 1 provided a protective effect for both overall and infectious complications (adjusted odds ratio [95% confidence interval], 0.63 [0.45, 0.88]; P=.006 and 0.64 [0.46, 0.90]; P=.010, respectively).ConclusionsIn a cohort of critically ill ACS patients, achieving FB (-) status early during surgical ICU admission was associated with a nearly 70% reduction in the risk for mortality.Copyright © 2014 Elsevier Inc. All rights reserved.

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