Emergency Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.
Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional, Mexico City, Mexico.
Postgrad Med J. 2018 Jul;94(1113):386-391. doi: 10.1136/postgradmedj-2018-135695. Epub 2018 Jun 20.
The aim of this study was to investigate the association of fluid overload, measured by bioelectrical impedance vector analysis (BIVA) and also by accumulated fluid balance, with 30-day mortality rates in patients admitted to the emergency department (ED).
We conducted a prospective observational study of fluid overload using BIVA, taking measures using a multiple-frequency whole-body tetrapolar equipment. Accumulated fluid balances were obtained at 24, 48 and 72 hours from ED admission and its association with 30-day mortality.
109 patients admitted to the ED classified as fluid overloaded by both methods.
According to BIVA, 71.6% (n=78) of patients had fluid overload on ED admission. These patients were older and had higher Sequential Organ Failure Assessment scores. During a median follow-up period of 30 days, 32.1% (n=25) of patients with fluid overload evaluated by BIVA died versus none with normovolaemia (p=0.001). There was no statistically significant difference in mortality between patients with and without fluid overload as assessed by accumulated fluid balance (p=0.81).
Fluid overload on admission evaluated by BIVA was significantly related to mortality in patients admitted to the ED.
本研究旨在探讨通过生物电阻抗向量分析（BIVA）和累计液体平衡测量的液体超负荷与急诊部（ED）入院患者 30 天死亡率之间的关系。
我们使用 BIVA 进行了一项前瞻性观察性液体超负荷研究，使用多频全身四极设备进行测量。在 ED 入院后 24、48 和 72 小时获得累计液体平衡，并将其与 30 天死亡率相关联。
109 名被归类为两种方法均存在液体超负荷的 ED 入院患者。
根据 BIVA，71.6%（n=78）的患者在 ED 入院时存在液体超负荷。这些患者年龄更大，序贯器官衰竭评估评分更高。在中位数为 30 天的随访期间，通过 BIVA 评估的液体超负荷患者中有 32.1%（n=25）死亡，而正常血容量患者无一例死亡（p=0.001）。通过累计液体平衡评估的液体超负荷患者与无液体超负荷患者之间的死亡率无统计学差异（p=0.81）。
ED 入院患者通过 BIVA 评估的入院时液体超负荷与死亡率显著相关。
