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Báo cáo y học: "Fluid balance as a biomarker: impact of fluid overload on outcome in critically ill patients with acute kidney injury"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Fluid balance as a biomarker: impact of fluid overload on outcome in critically ill patients with acute kidney injury. | Available online http ccforum.eom content 12 4 169 Commentary Fluid balance as a biomarker impact of fluid overload on outcome in critically ill patients with acute kidney injury Sean M Bagshaw1 Patrick D Brophy2 Dinna Cruz3 and Claudio Ronco3 1 Division of Critical Care Medicine Faculty of Medicine and Dentistry University of Alberta 3C1.12 Walter C Mackenzie Centre 8440-112 ST NW Edmonton T6G 2B7 Canada 2Division of Nephrology Hypertension Dialysis and Transplantation Department of Pediatrics 285 Newton Road 1269-A CBRB Iowa City Iowa 52242 USA 3Department of Nephrology Dialysis Transplantation San Bortolo Hospital Viale Rodolfi 37 36100 Vicenza Italy Corresponding author Claudio Ronco cronco@goldnet.it Published 24 July 2008 This article is online at http ccforum.com content 12 4 169 2008 BioMed Central Ltd Critical Care 2008 12 169 doi 10.1186 cc6948 See related research by Payen et al. http ccforum.com content 12 3 R74 Abstract Fluid therapy is fundamental to the acute resuscitation of critically ill patients. In general however early and appropriate goal-directed fluid therapy contributes to a degree of fluid overload in most if not all patients. Recent data imply that a threshold may exist beyond which after acute resuscitation additional fluid therapy may cause harm. In patients with acute kidney injury and or oliguria a positive fluid balance is almost universal. Few studies have examined the impact of fluid balance on clinical outcomes in critically ill adults with acute kidney injury. Payen and coworkers in a secondary analysis of the SOAP Sepsis Occurrence in Acutely Ill Patients study now present evidence that there is an independent association between mortality and positive fluid balance in a cohort of critically ill patients with acute kidney injury. In this commentary we discuss these findings within the context of prior literature and propose that assessment of fluid balance should be considered as a potentially valuable biomarker of critical .