• Journal of critical care · Apr 2018

    Association between postoperative fluid balance and acute kidney injury in patients after cardiac surgery: A retrospective cohort study.

    • Yanfei Shen, Weimin Zhang, Xuping Cheng, and Manzhen Ying.
    • Department of Intensive Care Unit, Dongyang People's Hospital, No. 60, Wuning West Road, Dongyang, Jinhua, Zhejiang 322100, PR China. Electronic address: snow.shen@hotmail.com.
    • J Crit Care. 2018 Apr 1; 44: 273-277.

    PurposeThe present study aims to explore appropriate postoperative fluid management in patients after cardiac surgery.Materials And MethodsData were extracted from an online database. Associations between fluid balance (FB), fluid intake and mortality were investigated.ResultsCompared to zero FB (level 3), more negative FB (level 1, odds ratio (OR): 0.938, 95% CI: 0.631-1.394; level 2, OR: 0.921, 95% CI: 0.709-1.196) could not further decrease AKI incidence while positive FB was associated with higher AKI incidence (level 4, OR: 1.272, 95% CI: 1.028-1.573; level 5, OR: 2.042, 95% CI: 1.652-2.524). Both limited (level 1, OR: 1.354, 95% CI: 1.065-1.699) and increased postoperative fluid intake (level 3, OR: 1.127, 95% CI: 0.890-1.430; to level 5, OR: 1.405, 95% CI: 1.105-1.786) were associated with increased AKI incidence, compared to level 2. Multivariable logistic models using linear spline function showed a similar pattern.ConclusionsCompared to zero FB, postoperative positive FB was associated with higher AKI incidence. Yet, the association between negative FB and AKI was insignificant. A "U"-shape association between postoperative fluid intake and AKI was detected.Copyright © 2017. Published by Elsevier Inc.

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