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| 1 | Association of fluid balance trajectories with clinical outcomes in patients with septic shock:A prospective multicenter cohort study显示文摘Background:Septic shock has a high incidence and mortality rate in Intensive Care Units(ICUs).Earlier intravenous fluid resuscitation can significantly improve outcomes in septic patients but easily leads to fluid overload(FO),which is associated with poor clinical outcomes.A single point value of fluid cannot provide enough fluid information.The aim of this study was to investigate the impact of fluid balance(FB)latent trajectories on clinical outcomes in septic patients.Methods:Patients were diagnosed with septic shock during the first 48 h,and sequential fluid data for the first 3 days of ICU admission were included.A group-based trajectory model(GBTM)which is designed to identify groups of individuals following similar developmental trajectories was used to identify latent subgroups of individuals following a similar progression of FB.The primary outcomes were hospital mortality,organ dysfunction,major adverse kidney events(MAKE)and severe respiratory adverse events(SRAE).We used multivariable Cox or logistic regression analysis to assess the association between FB trajectories and clinical outcomes.Results:Nine hundred eighty-six patients met the inclusion criteria and were assigned to GBTM analysis,and three latent FB trajectories were detected.64(6.5%),841(85.3%),and 81(8.2%)patients were identified to have decreased,low,and high FB,respectively.Compared with low FB,high FB was associated with increased hospital mortality[hazard ratio(HR)=1.63,95%CI 1.22–2.17],organ dysfunction[odds ratio(OR)=2.18,95%CI 1.22–3.42],MAKE(OR=1.80,95%CI 1.04–2.63)and SRAE(OR=2.33,95%CI 1.46–3.71),and decreasing FB was significantly associated with decreased MAKE(OR=0.46,95%CI 0.29–0.79)after adjustment for potential covariates.Conclusion:Latent subgroups of septic patients followed a similar FB progression.These latent fluid trajectories were associated with clinical outcomes.The decreasing FB trajectory was associated with a decreased risk of hospital mortality and MAKE. | Mei-Ping Wang Li Jiang Bo Zhu Bin Du Wen Li Yan He Xiu-Ming Xi China Critical Care Sepsis Trial(CCCST)workgroup | 2021 | Military Medical Research2021，8，3： | 4 |
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| 15 | Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock, 2012 显示文摘 | Dellinger RP Levy MM Rhodes A Surviving Sepsis Campaign Guidelines Committee including The Pediatric Sub- group | 2013 | Inten- sive Care Med2013，39，2： | 1 |
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| 18 | Severity of illness and organ dysfunction scoring in children 显示文摘 | Lacroix J Cotting J Pediatric Acute Lung Injury and Sepsis Investi- gators (PALISI) Network | 2005 | Pediatr Crit Care Med2005，6，3： | 1 |
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