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PS-138 Fluid Overload Is Associated With Mortality In Paediatric Acute Respiratory Distress Syndrome (ards) Only In The Setting Of Acute Kidney Injury (aki)
  1. A Spicer1,
  2. V Lo1,
  3. RG Khemani2,
  4. HR Flori3,
  5. CS Calfee4,
  6. MA Matthay4,
  7. A Sapru1,
  8. B Orwoll1
  1. 1Pediatrics, University of California San Francisco, San Francisco, USA
  2. 2Critical Care, Children’s Hospital of Los Angeles, Los Angeles, USA
  3. 3Critical Care, Children’s Hospital and Research Center Oakland, Oakland, USA
  4. 4Medicine, University of California San Francisco, San Francisco, USA

Abstract

Background Cumulative fluid balance on day 3 is associated with mortality in paediatric ARDS (Valentine 2012, Willson 2013). Whether this association is modified by AKI is unknown.

Aim To test the effect of AKI on the association between fluid and mortality in ARDS.

Methods We calculated cumulative fluid balance 3 days after ARDS onset in a multi-centre cohort. AKI was defined as ‘Injury’ or ‘Failure’ by pRIFLE criteria (Akcan-Arikan 2007).

Results Patient characteristics are shown in Table 1. Mortality was higher in patients with AKI.

Fluid balance was associated with mortality independent of sex, age, race, PRISM 3 and vasopressor use; upon stratification, this association was to limited patients with AKI (Table 2 and Figure).

Abstract PS-138 Table 1

Patient characteristics

Abstract PS-138 Table 2

Logistic regression model adjusted for age, sex, race, PRISM 3 and inotrope useoutcome: mortality predictor: day 3 fluid balance (100 mL/kg)

Conclusions Day 3 cumulative fluid balance and AKI are associated with mortality. The association with fluid balance is limited to patients with AKI. This has important implications for fluid management in ARDS patients.

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