Association between fluid balance at different time points and mortality in patients with septic shock: a meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

JIANG Junmeng ,  CHENG Yifeng , LI Ji , SHAO Hong , WANG Baiyong , ZHANG Chao

Department of Critical Care Medicine, The Affiliated Hospital of Hangzhou Normal University, Hangzhou 310015, P. R. China;

Corresponding?author：

CHENG Yifeng, Email: 724661969@qq.com

Keywords：

Septic shock; Fluid balance; Fluid resuscitation; Fluid de-resuscitation; Fluid overload; Mortality; Meta-analysis

DOI：

10.7507/1672-2531.202601053

Video：

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Objective To systematically evaluate the association between fluid balance at different time points and mortality in patients with septic shock, and to provide evidence-based guidance for optimal timing of fluid management in clinical practice. Methods We electronically searched CNKI, WanFang Data, VIP, CBM, PubMed, Embase, Web of Science, and Cochrane Library databases from inception to December 2024 for original studies investigating the relationship between fluid balance and mortality in patients with septic shock. Two reviewers independently screened literature, extracted data, and assessed risk of bias. Meta-analyses were performed using Stata 16.0 and RevMan 5.4 software. Results A total of 16 original studies involving 36 573 patients with sepsis or septic shock were included. Meta-analysis showed that 24 hours fluid balance was not significantly associated with mortality (OR=0.92, 95%CI 0.71 to 1.19, P=0.52), suggesting a potential protective effect of early moderate positive fluid balance; 48 hours cumulative positive fluid balance was significantly associated with increased mortality (OR=1.52, 95%CI 1.28 to 1.81, P<0.001); this association strengthened further at 72 hours (RR=1.65, 95%CI 1.38 to 1.98, P<0.001); and a fluid accumulation index >0.42 was also significantly linked to higher in-hospital mortality (OR=1.46, 95%CI 1.10 to 1.95, P<0.05). Subgroup analyses based on 72 hours fluid balance demonstrated consistent results across study designs, geographic regions, sample sizes, sepsis diagnostic criteria, and adjustment for confounders. Sensitivity analyses and publication bias assessments confirmed the robustness of the findings. Conclusion The impact of fluid balance on mortality in septic shock exhibits clear time dependency: moderate positive fluid balance within the first 24 hours may be beneficial, but sustained positive balance beyond 48 hours is significantly associated with increased mortality, with 72 hours representing a critical window. It is recommended to transition to a restrictive fluid strategy within 48–72 hours after initial resuscitation, and to initiate fluid de-resuscitation in patients without fluid responsiveness to improve outcomes.

Citation： JIANG Junmeng, CHENG Yifeng, LI Ji, SHAO Hong, WANG Baiyong, ZHANG Chao. Association between fluid balance at different time points and mortality in patients with septic shock: a meta-analysis. Chinese Journal of Evidence-Based Medicine, 2026, 26(9): 1028-1037. doi: 10.7507/1672-2531.202601053 Copy

1.	Rudd KE, Johnson SC, Agesa KM, et al. Global, regional, and national sepsis incidence and mortality, 1990-2017: analysis for the Global Burden of Disease Study[J]. Lancet, 2020, 395(10219): 200-211.
2.	Singer M, Deutschman CS, Seymour CW, et al. The third international consensus definitions for sepsis and septic shock (Sepsis-3)[J]. JAMA, 2016, 315(8): 801-810.
3.	Vincent JL, Jones G, David S, et al. Frequency and mortality of septic shock in Europe and North America: a systematic review and meta-analysis[J]. Crit Care, 2019, 23(1): 196.
4.	Acheampong A, Vincent JL. A positive fluid balance is an independent prognostic factor in patients with sepsis[J]. Crit Care, 2015, 19: 251.
5.	Malbrain ML, Marik PE, Witters I, et al. Fluid overload, de-resuscitation, and outcomes in critically ill or injured patients: a systematic review with suggestions for clinical practice[J]. Anaesthesiol Intensive Ther, 2014, 46(5): 361-380.
6.	Rivers E, Nguyen B, Havstad S, et al. Early goal-directed therapy in the treatment of severe sepsis and septic shock[J]. N Engl J Med, 2001, 345(19): 1368-1377.
7.	National Heart, Lung, and Blood Institute Acute Respiratory Distress Syndrome (ARDS) Clinical Trials Network. Comparison of two fluid-management strategies in acute lung injury[J]. N Engl J Med, 2006, 354(24): 2564-2575.
8.	Prowle JR, Echeverri JE, Ligabo EV, et al. Fluid balance and acute kidney injury[J]. Nat Rev Nephrol, 2010, 6(2): 107-115.
9.	Malbrain ML, Chiumello D, Pelosi P, et al. Incidence and prognosis of intraabdominal hypertension in a mixed population of critically ill patients: a multiple-center epidemiological study[J]. Crit Care Med, 2005, 33(2): 315-322.
10.	Boyd JH, Forbes J, Nakada TA, et al. Fluid resuscitation in septic shock: a positive fluid balance and elevated central venous pressure are associated with increased mortality[J]. Crit Care Med, 2011, 39(2): 259-265.
11.	Vincent JL, Sakr Y, Sprung CL, et al. Sepsis in European intensive care units: results of the SOAP study[J]. Crit Care Med, 2006, 34(2): 344-353.
12.	Payen D, De Pont AC, Sakr Y, et al. A positive fluid balance is associated with a worse outcome in patients with acute renal failure[J]. Crit Care, 2008, 12(3): R74.
13.	Sadaka F, Juarez M, Naydenov S, et al. Fluid resuscitation in septic shock: the effect of increasing fluid balance on mortality[J]. J Intensive Care Med, 2014, 29(4): 213-217.
14.	Zhang Z, Zhu C, Fu P, et al. Cumulative fluid accumulation is associated with the development of acute kidney injury and non-recovery of renal function: a systematic review and meta-analysis[J]. Crit Care, 2019, 23(1): 392.
15.	Cordemans C, De Laet I, Van Regenmortel N, et al. Fluid management in critically ill patients: the role of extravascular lung water, abdominal hypertension, capillary leak, and fluid balance[J]. Ann Intensive Care, 2012, 2(Suppl 1): S1.
16.	Malbrain ML, Van Regenmortel N, Saugel B, et al. Principles of fluid management and stewardship in septic shock: it is time to consider the four D's and the four phases of fluid therapy[J]. Ann Intensive Care, 2018, 8(1): 66.
17.	Goldstein SL, Currier H, Graf CD, et al. Outcome in children receiving continuous venovenous hemofiltration[J]. Pediatrics, 2001, 107(6): 1309-1312.
18.	Schuller D, Mitchell JP, Calandri FS, et al. Fluid balance during pulmonary edema. Is fluid gain a marker or a cause of poor outcome[J]? Chest, 1991, 100(4): 1068-1075.
19.	Hoste EA, Maitland K, Brudney CS, et al. Four phases of intravenous fluid therapy: a conceptual model[J]. Br J Anaesth, 2014, 113(5): 740-747.
20.	Mitchell KH, Carlbom D, Caldwell E, et al. Volume overload: prevalence, risk factors, and functional outcome in survivors of septic shock[J]. Ann Am Thorac Soc, 2015, 12(12): 1837-1844.
21.	Silversides JA, Major E, Ferguson AJ, et al. Conservative fluid management or deresuscitation for patients with sepsis or acute respiratory distress syndrome following the resuscitation phase of critical illness: a systematic review and meta-analysis[J]. Intensive Care Med, 2017, 43(2): 155-170.
22.	Marik PE, Lemson J. Fluid responsiveness: an evolution of our understanding[J]. Br J Anaesth, 2014, 112(4): 617-620.
23.	Messmer AS, Zingg C, Müller M, et al. Fluid overload and mortality in adult critical care patients: a systematic review and meta-analysis of observational studies[J]. Crit Care Med, 2020, 48(12): 1862-1870.
24.	Tigabu BM, Davari M, Kebriaeezadeh A, et al. Fluid volume, fluid balance and patient outcome in severe sepsis and septic shock: a systematic review[J]. J Crit Care, 2018, 48: 153-159.
25.	Page MJ, McKenzie JE, Bossuyt PM, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews[J]. BMJ, 2021, 372: n71.
26.	穆宇航. 液體積聚指數與膿毒癥合并心力衰竭患者死亡風險的相關性研究[D]. 長春: 吉林大學, 2024.
27.	齊穎, 陳兵. 膿毒性休克限制性液體復蘇的臨床研究[J]. 天津醫科大學學報, 2015, 21(3): 234-236.
28.	黃蓉, 董艷, 周燕, 等. 液體平衡與膿毒癥患者預后的時間相關性研究[J]. 中華危重病急救醫學, 2023, 35(11): 1182-1187.
29.	馬帥, 張汝敏, 王世富, 等. GEDVI指導老年膿毒癥休克患者液體復蘇的效果[J]. 中國急救醫學, 2017, 37(8): 738-741.
30.	余琨. 重癥超聲引導的早期液體復蘇在膿毒性休克中的臨床應用[D]. 遵義: 遵義醫科大學, 2020.
31.	Douglas IS, Alapat PM, Corl KA, et al. Fluid response evaluation in sepsis hypotension and shock: a randomized clinical trial[J]. Chest, 2020, 158(4): 1431-1445.
32.	Chen Y, Li X, Wang S, et al. Blood pressure response index and clinical outcomes in patients with septic shock: a multicenter cohort study[J]. EBioMedicine, 2024, 99: 104applause.
33.	Sirvent JM, Ferri C, Baró A, et al. Fluid balance in sepsis and septic shock as a determining factor of mortality[J]. Am J Emerg Med, 2015, 33(2): 186-189.
34.	Guo Y, Takahashi N, Matsumoto S, et al. Early fluid balance is associated with 90-day mortality in patients receiving continuous renal replacement therapy[J]. Acta Med Okayama, 2023, 77(1): 45-52.
35.	Sakr Y, Rubatto Birri PN, Kotfis K, et al. Higher fluid balance increases the risk of death from sepsis: results from a large international audit[J]. Crit Care Med, 2017, 45(3): 386-394.
36.	Kelm DJ, Perrin JT, Cartin-Ceba R, et al. Fluid overload in patients with severe sepsis and septic shock treated with early goal-directed therapy is associated with increased acute need for fluid-related medical interventions and hospital death[J]. Shock, 2015, 43(1): 68-73.
37.	Dong N, Chen M, Yang Y, et al. Association of fluid management with mortality of sepsis patients with congestive heart failure: a retrospective cohort study[J]. Front Med (Lausanne), 2022, 9: 868131.
38.	De Souza MA, Da Silva Ramos FJ, Svicero BS, et al. Assessment of the components of fluid balance in patients with septic shock: a prospective observational study[J]. Braz J Anesthesiol, 2024, 74(2): 844483.
39.	Cronhjort M, Hjortrup PB, Holst LB, et al. Association between fluid balance and mortality in patients with septic shock: a post hoc analysis of the TRISS trial[J]. Acta Anaesthesiol Scand, 2016, 60(7): 925-933.
40.	Brotfain E, Koyfman L, Toledano R, et al. Positive fluid balance as a major predictor of clinical outcome of patients with sepsis/septic shock after ICU discharge[J]. Am J Emerg Med, 2016, 34(11): 2122-2126.
41.	Garzotto F, Ostermann M, Martín-Langerwerf D, et al. The Dose Response Multicentre Investigation on Fluid Assessment (DoReMIFA) in critically ill patients[J]. Crit Care, 2016, 20(1): 196.
42.	Ince C, Mayeux PR, Nguyen T, et al. The endothelium in sepsis[J]. Shock, 2016, 45(3): 259-270.
43.	Levy MM, Evans LE, Rhodes A. The surviving sepsis campaign bundle: 2018 update[J]. Intensive Care Med, 2018, 44(6): 925-928.
44.	Chappell D, Jacob M, Hofmann-Kiefer K, et al. A rational approach to perioperative fluid management[J]. Anesthesiology, 2008, 109(4): 723-740.
45.	Woodcock TE, Woodcock TM. Revised Starling equation and the glycocalyx model of transvascular fluid exchange: an improved paradigm for prescribing intravenous fluid therapy[J]. Br J Anaesth, 2012, 108(3): 384-394.
46.	Ware LB, Matthay MA. The acute respiratory distress syndrome[J]. N Engl J Med, 2000, 342(18): 1334-1349.
47.	Murphy CV, Schramm GE, Doherty JA, et al. The importance of fluid management in acute lung injury secondary to septic shock[J]. Chest, 2009, 136(1): 102-109.
48.	Marik P, Bellomo R. A rational approach to fluid therapy in sepsis[J]. Br J Anaesth, 2016, 116(3): 339-349.
49.	Legrand M, Dupuis C, Simon C, et al. Association between systemic hemodynamics and septic acute kidney injury in critically ill patients: a retrospective observational study[J]. Crit Care, 2013, 17(6): R278.
50.	Bouchard J, Soroko SB, Chertow GM, et al. Fluid accumulation, survival and recovery of kidney function in critically ill patients with acute kidney injury[J]. Kidney Int, 2009, 76(4): 422-427.
51.	Malbrain ML, Cheatham ML, Kirkpatrick A, et al. Results from the International Conference of Experts on Intra-abdominal Hypertension and Abdominal Compartment Syndrome I. Definitions[J]. Intensive Care Med, 2006, 32(11): 1722-1732.
52.	Holcomb JB, Tilley BC, Baraniuk S, et al. Transfusion of plasma, platelets, and red blood cells in a 1: 1: 1 vs a 1: 1: 2 ratio and mortality in patients with severe trauma: the PROPPR randomized clinical trial[J]. JAMA, 2015, 313(5): 471-482.
53.	Finfer S, Bellomo R, Boyce N, et al. A comparison of albumin and saline for fluid resuscitation in the intensive care unit[J]. N Engl J Med, 2004, 350(22): 2247-2256.
54.	Vincent JL, De Backer D. Circulatory shock[J]. N Engl J Med, 2013, 369(18): 1726-1734.
55.	Cecconi M, Hofer C, Teboul JL, et al. Fluid challenges in intensive care: the FENICE study[J]. Intensive Care Med, 2015, 41(9): 1529-1537.
56.	Vaara ST, Korhonen AM, Kaukonen KM, et al. Fluid overload is associated with an increased risk for 90-day mortality in critically ill patients with renal replacement therapy: data from the prospective FINNAKI study[J]. Crit Care, 2012, 16(5): R197.
57.	Marik PE, Cavallazzi R. Does the central venous pressure predict fluid responsiveness. An updated meta-analysis and a plea for some common sense[J]. Crit Care Med, 2013, 41(7): 1774-1781.
58.	Martin GS, Moss M, Wheeler AP, et al. A randomized, controlled trial of furosemide with or without albumin in hypoproteinemic patients with acute lung injury[J]. Crit Care Med, 2005, 33(8): 1681-1687.
59.	Bellomo R, Cass A, Cole L, et al. Intensity of continuous renal-replacement therapy in critically ill patients[J]. N Engl J Med, 2009, 361(17): 1627-1638.
60.	Bissell BD, Laine ME, Thompson Bastin ML, et al. Impact of protocolized diuresis for de-resuscitation in the intensive care unit[J]. Crit Care, 2020, 24(1): 70.
61.	Claure-Del Granado R, Mehta RL. Fluid overload in the ICU: evaluation and management[J]. BMC Nephrol, 2016, 17(1): 109.
62.	Singer P, Blaser AR, Berger MM, et al. ESPEN guideline on clinical nutrition in the intensive care unit[J]. Clin Nutr, 2019, 38(1): 48-79.
63.	Sakr Y, Vincent JL, Reinhart K, et al. High tidal volume and positive fluid balance are associated with worse outcome in acute lung injury[J]. Chest, 2005, 128(5): 3098-3108.
64.	Neyra JA, Li X, Canepa-Escaro F, et al. Cumulative fluid balance and mortality in septic patients with or without acute kidney injury and chronic kidney disease[J]. Crit Care Med, 2016, 44(10): 1891-1900.
65.	Evans L, Rhodes A, Alhazzani W, et al. Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021[J]. Intensive Care Med, 2021, 47(11): 1181-1247.
66.	Meyhoff TS, Hjortrup PB, Wetterslev J, et al. Restriction of intravenous fluid in ICU patients with septic shock[J]. N Engl J Med, 2022, 386(26): 2459-2470.
67.	Myles PS, Bellomo R, Corcoran T, et al. Restrictive versus liberal fluid therapy for major abdominal surgery[J]. N Engl J Med, 2018, 378(24): 2263-2274.
68.	Silversides JA, Fitzgerald E, Manickavasagam US, et al. Deresuscitation of patients with iatrogenic fluid overload is associated with reduced mortality in critical illness[J]. Crit Care Med, 2018, 46(10): 1600-1607.
69.	Monnet X, Marik P, Teboul JL. Passive leg raising for predicting fluid responsiveness: a systematic review and meta-analysis[J]. Intensive Care Med, 2016, 42(12): 1935-1947.
70.	Michard F, Teboul JL. Predicting fluid responsiveness in ICU patients: a critical analysis of the evidence[J]. Chest, 2002, 121(6): 2000-2008.
71.	Bentzer P, Griesdale DE, Boyd J, et al. Will this hemodynamically unstable patient respond to a bolus of intravenous fluids[J]. JAMA, 2016, 316(12): 1298-1309.
72.	Higgins JP, Thompson SG, Deeks JJ, et al. Measuring inconsistency in meta-analyses[J]. BMJ, 2003, 327(7414): 557-560.
73.	Hernán MA, Hernández-Díaz S, Robins JM. A structural approach to selection bias[J]. Epidemiology, 2004, 15(5): 615-625.
74.	Myburgh JA, Finfer S, Bellomo R, et al. Hydroxyethyl starch or saline for fluid resuscitation in intensive care[J]. N Engl J Med, 2012, 367(20): 1901-1911.
75.	Prowle JR, Bellomo R. Fluid administration and the kidney[J]. Curr Opin Crit Care, 2010, 16(4): 332-336.
76.	Egger M, Smith GD, Schneider M, et al. Bias in meta-analysis detected by a simple, graphical test[J]. BMJ, 1997, 315(7109): 629-634.
77.	Shankar-Hari M, Phillips GS, Levy ML, et al. Developing a new definition and assessing new clinical criteria for septic shock: for the third international consensus definitions for sepsis and septic shock (Sepsis-3)[J]. JAMA, 2016, 315(8): 775-787.
78.	Seymour CW, Liu VX, Iwashyna TJ, et al. Assessment of clinical criteria for sepsis: for the third international consensus definitions for sepsis and septic shock (Sepsis-3)[J]. JAMA, 2016, 315(8): 762-774.

1. Rudd KE, Johnson SC, Agesa KM, et al. Global, regional, and national sepsis incidence and mortality, 1990-2017: analysis for the Global Burden of Disease Study[J]. Lancet, 2020, 395(10219): 200-211.
2. Singer M, Deutschman CS, Seymour CW, et al. The third international consensus definitions for sepsis and septic shock (Sepsis-3)[J]. JAMA, 2016, 315(8): 801-810.
3. Vincent JL, Jones G, David S, et al. Frequency and mortality of septic shock in Europe and North America: a systematic review and meta-analysis[J]. Crit Care, 2019, 23(1): 196.
4. Acheampong A, Vincent JL. A positive fluid balance is an independent prognostic factor in patients with sepsis[J]. Crit Care, 2015, 19: 251.
5. Malbrain ML, Marik PE, Witters I, et al. Fluid overload, de-resuscitation, and outcomes in critically ill or injured patients: a systematic review with suggestions for clinical practice[J]. Anaesthesiol Intensive Ther, 2014, 46(5): 361-380.
6. Rivers E, Nguyen B, Havstad S, et al. Early goal-directed therapy in the treatment of severe sepsis and septic shock[J]. N Engl J Med, 2001, 345(19): 1368-1377.
7. National Heart, Lung, and Blood Institute Acute Respiratory Distress Syndrome (ARDS) Clinical Trials Network. Comparison of two fluid-management strategies in acute lung injury[J]. N Engl J Med, 2006, 354(24): 2564-2575.
8. Prowle JR, Echeverri JE, Ligabo EV, et al. Fluid balance and acute kidney injury[J]. Nat Rev Nephrol, 2010, 6(2): 107-115.
9. Malbrain ML, Chiumello D, Pelosi P, et al. Incidence and prognosis of intraabdominal hypertension in a mixed population of critically ill patients: a multiple-center epidemiological study[J]. Crit Care Med, 2005, 33(2): 315-322.
10. Boyd JH, Forbes J, Nakada TA, et al. Fluid resuscitation in septic shock: a positive fluid balance and elevated central venous pressure are associated with increased mortality[J]. Crit Care Med, 2011, 39(2): 259-265.
11. Vincent JL, Sakr Y, Sprung CL, et al. Sepsis in European intensive care units: results of the SOAP study[J]. Crit Care Med, 2006, 34(2): 344-353.
12. Payen D, De Pont AC, Sakr Y, et al. A positive fluid balance is associated with a worse outcome in patients with acute renal failure[J]. Crit Care, 2008, 12(3): R74.
13. Sadaka F, Juarez M, Naydenov S, et al. Fluid resuscitation in septic shock: the effect of increasing fluid balance on mortality[J]. J Intensive Care Med, 2014, 29(4): 213-217.
14. Zhang Z, Zhu C, Fu P, et al. Cumulative fluid accumulation is associated with the development of acute kidney injury and non-recovery of renal function: a systematic review and meta-analysis[J]. Crit Care, 2019, 23(1): 392.
15. Cordemans C, De Laet I, Van Regenmortel N, et al. Fluid management in critically ill patients: the role of extravascular lung water, abdominal hypertension, capillary leak, and fluid balance[J]. Ann Intensive Care, 2012, 2(Suppl 1): S1.
16. Malbrain ML, Van Regenmortel N, Saugel B, et al. Principles of fluid management and stewardship in septic shock: it is time to consider the four D's and the four phases of fluid therapy[J]. Ann Intensive Care, 2018, 8(1): 66.
17. Goldstein SL, Currier H, Graf CD, et al. Outcome in children receiving continuous venovenous hemofiltration[J]. Pediatrics, 2001, 107(6): 1309-1312.
18. Schuller D, Mitchell JP, Calandri FS, et al. Fluid balance during pulmonary edema. Is fluid gain a marker or a cause of poor outcome[J]? Chest, 1991, 100(4): 1068-1075.
19. Hoste EA, Maitland K, Brudney CS, et al. Four phases of intravenous fluid therapy: a conceptual model[J]. Br J Anaesth, 2014, 113(5): 740-747.
20. Mitchell KH, Carlbom D, Caldwell E, et al. Volume overload: prevalence, risk factors, and functional outcome in survivors of septic shock[J]. Ann Am Thorac Soc, 2015, 12(12): 1837-1844.
21. Silversides JA, Major E, Ferguson AJ, et al. Conservative fluid management or deresuscitation for patients with sepsis or acute respiratory distress syndrome following the resuscitation phase of critical illness: a systematic review and meta-analysis[J]. Intensive Care Med, 2017, 43(2): 155-170.
22. Marik PE, Lemson J. Fluid responsiveness: an evolution of our understanding[J]. Br J Anaesth, 2014, 112(4): 617-620.
23. Messmer AS, Zingg C, Müller M, et al. Fluid overload and mortality in adult critical care patients: a systematic review and meta-analysis of observational studies[J]. Crit Care Med, 2020, 48(12): 1862-1870.
24. Tigabu BM, Davari M, Kebriaeezadeh A, et al. Fluid volume, fluid balance and patient outcome in severe sepsis and septic shock: a systematic review[J]. J Crit Care, 2018, 48: 153-159.
25. Page MJ, McKenzie JE, Bossuyt PM, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews[J]. BMJ, 2021, 372: n71.
26. 穆宇航. 液體積聚指數與膿毒癥合并心力衰竭患者死亡風險的相關性研究[D]. 長春: 吉林大學, 2024.
27. 齊穎, 陳兵. 膿毒性休克限制性液體復蘇的臨床研究[J]. 天津醫科大學學報, 2015, 21(3): 234-236.
28. 黃蓉, 董艷, 周燕, 等. 液體平衡與膿毒癥患者預后的時間相關性研究[J]. 中華危重病急救醫學, 2023, 35(11): 1182-1187.
29. 馬帥, 張汝敏, 王世富, 等. GEDVI指導老年膿毒癥休克患者液體復蘇的效果[J]. 中國急救醫學, 2017, 37(8): 738-741.
30. 余琨. 重癥超聲引導的早期液體復蘇在膿毒性休克中的臨床應用[D]. 遵義: 遵義醫科大學, 2020.
31. Douglas IS, Alapat PM, Corl KA, et al. Fluid response evaluation in sepsis hypotension and shock: a randomized clinical trial[J]. Chest, 2020, 158(4): 1431-1445.
32. Chen Y, Li X, Wang S, et al. Blood pressure response index and clinical outcomes in patients with septic shock: a multicenter cohort study[J]. EBioMedicine, 2024, 99: 104applause.
33. Sirvent JM, Ferri C, Baró A, et al. Fluid balance in sepsis and septic shock as a determining factor of mortality[J]. Am J Emerg Med, 2015, 33(2): 186-189.
34. Guo Y, Takahashi N, Matsumoto S, et al. Early fluid balance is associated with 90-day mortality in patients receiving continuous renal replacement therapy[J]. Acta Med Okayama, 2023, 77(1): 45-52.
35. Sakr Y, Rubatto Birri PN, Kotfis K, et al. Higher fluid balance increases the risk of death from sepsis: results from a large international audit[J]. Crit Care Med, 2017, 45(3): 386-394.
36. Kelm DJ, Perrin JT, Cartin-Ceba R, et al. Fluid overload in patients with severe sepsis and septic shock treated with early goal-directed therapy is associated with increased acute need for fluid-related medical interventions and hospital death[J]. Shock, 2015, 43(1): 68-73.
37. Dong N, Chen M, Yang Y, et al. Association of fluid management with mortality of sepsis patients with congestive heart failure: a retrospective cohort study[J]. Front Med (Lausanne), 2022, 9: 868131.
38. De Souza MA, Da Silva Ramos FJ, Svicero BS, et al. Assessment of the components of fluid balance in patients with septic shock: a prospective observational study[J]. Braz J Anesthesiol, 2024, 74(2): 844483.
39. Cronhjort M, Hjortrup PB, Holst LB, et al. Association between fluid balance and mortality in patients with septic shock: a post hoc analysis of the TRISS trial[J]. Acta Anaesthesiol Scand, 2016, 60(7): 925-933.
40. Brotfain E, Koyfman L, Toledano R, et al. Positive fluid balance as a major predictor of clinical outcome of patients with sepsis/septic shock after ICU discharge[J]. Am J Emerg Med, 2016, 34(11): 2122-2126.
41. Garzotto F, Ostermann M, Martín-Langerwerf D, et al. The Dose Response Multicentre Investigation on Fluid Assessment (DoReMIFA) in critically ill patients[J]. Crit Care, 2016, 20(1): 196.
42. Ince C, Mayeux PR, Nguyen T, et al. The endothelium in sepsis[J]. Shock, 2016, 45(3): 259-270.
43. Levy MM, Evans LE, Rhodes A. The surviving sepsis campaign bundle: 2018 update[J]. Intensive Care Med, 2018, 44(6): 925-928.
44. Chappell D, Jacob M, Hofmann-Kiefer K, et al. A rational approach to perioperative fluid management[J]. Anesthesiology, 2008, 109(4): 723-740.
45. Woodcock TE, Woodcock TM. Revised Starling equation and the glycocalyx model of transvascular fluid exchange: an improved paradigm for prescribing intravenous fluid therapy[J]. Br J Anaesth, 2012, 108(3): 384-394.
46. Ware LB, Matthay MA. The acute respiratory distress syndrome[J]. N Engl J Med, 2000, 342(18): 1334-1349.
47. Murphy CV, Schramm GE, Doherty JA, et al. The importance of fluid management in acute lung injury secondary to septic shock[J]. Chest, 2009, 136(1): 102-109.
48. Marik P, Bellomo R. A rational approach to fluid therapy in sepsis[J]. Br J Anaesth, 2016, 116(3): 339-349.
49. Legrand M, Dupuis C, Simon C, et al. Association between systemic hemodynamics and septic acute kidney injury in critically ill patients: a retrospective observational study[J]. Crit Care, 2013, 17(6): R278.
50. Bouchard J, Soroko SB, Chertow GM, et al. Fluid accumulation, survival and recovery of kidney function in critically ill patients with acute kidney injury[J]. Kidney Int, 2009, 76(4): 422-427.
51. Malbrain ML, Cheatham ML, Kirkpatrick A, et al. Results from the International Conference of Experts on Intra-abdominal Hypertension and Abdominal Compartment Syndrome I. Definitions[J]. Intensive Care Med, 2006, 32(11): 1722-1732.
52. Holcomb JB, Tilley BC, Baraniuk S, et al. Transfusion of plasma, platelets, and red blood cells in a 1: 1: 1 vs a 1: 1: 2 ratio and mortality in patients with severe trauma: the PROPPR randomized clinical trial[J]. JAMA, 2015, 313(5): 471-482.
53. Finfer S, Bellomo R, Boyce N, et al. A comparison of albumin and saline for fluid resuscitation in the intensive care unit[J]. N Engl J Med, 2004, 350(22): 2247-2256.
54. Vincent JL, De Backer D. Circulatory shock[J]. N Engl J Med, 2013, 369(18): 1726-1734.
55. Cecconi M, Hofer C, Teboul JL, et al. Fluid challenges in intensive care: the FENICE study[J]. Intensive Care Med, 2015, 41(9): 1529-1537.
56. Vaara ST, Korhonen AM, Kaukonen KM, et al. Fluid overload is associated with an increased risk for 90-day mortality in critically ill patients with renal replacement therapy: data from the prospective FINNAKI study[J]. Crit Care, 2012, 16(5): R197.
57. Marik PE, Cavallazzi R. Does the central venous pressure predict fluid responsiveness. An updated meta-analysis and a plea for some common sense[J]. Crit Care Med, 2013, 41(7): 1774-1781.
58. Martin GS, Moss M, Wheeler AP, et al. A randomized, controlled trial of furosemide with or without albumin in hypoproteinemic patients with acute lung injury[J]. Crit Care Med, 2005, 33(8): 1681-1687.
59. Bellomo R, Cass A, Cole L, et al. Intensity of continuous renal-replacement therapy in critically ill patients[J]. N Engl J Med, 2009, 361(17): 1627-1638.
60. Bissell BD, Laine ME, Thompson Bastin ML, et al. Impact of protocolized diuresis for de-resuscitation in the intensive care unit[J]. Crit Care, 2020, 24(1): 70.
61. Claure-Del Granado R, Mehta RL. Fluid overload in the ICU: evaluation and management[J]. BMC Nephrol, 2016, 17(1): 109.
62. Singer P, Blaser AR, Berger MM, et al. ESPEN guideline on clinical nutrition in the intensive care unit[J]. Clin Nutr, 2019, 38(1): 48-79.
63. Sakr Y, Vincent JL, Reinhart K, et al. High tidal volume and positive fluid balance are associated with worse outcome in acute lung injury[J]. Chest, 2005, 128(5): 3098-3108.
64. Neyra JA, Li X, Canepa-Escaro F, et al. Cumulative fluid balance and mortality in septic patients with or without acute kidney injury and chronic kidney disease[J]. Crit Care Med, 2016, 44(10): 1891-1900.
65. Evans L, Rhodes A, Alhazzani W, et al. Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021[J]. Intensive Care Med, 2021, 47(11): 1181-1247.
66. Meyhoff TS, Hjortrup PB, Wetterslev J, et al. Restriction of intravenous fluid in ICU patients with septic shock[J]. N Engl J Med, 2022, 386(26): 2459-2470.
67. Myles PS, Bellomo R, Corcoran T, et al. Restrictive versus liberal fluid therapy for major abdominal surgery[J]. N Engl J Med, 2018, 378(24): 2263-2274.
68. Silversides JA, Fitzgerald E, Manickavasagam US, et al. Deresuscitation of patients with iatrogenic fluid overload is associated with reduced mortality in critical illness[J]. Crit Care Med, 2018, 46(10): 1600-1607.
69. Monnet X, Marik P, Teboul JL. Passive leg raising for predicting fluid responsiveness: a systematic review and meta-analysis[J]. Intensive Care Med, 2016, 42(12): 1935-1947.
70. Michard F, Teboul JL. Predicting fluid responsiveness in ICU patients: a critical analysis of the evidence[J]. Chest, 2002, 121(6): 2000-2008.
71. Bentzer P, Griesdale DE, Boyd J, et al. Will this hemodynamically unstable patient respond to a bolus of intravenous fluids[J]. JAMA, 2016, 316(12): 1298-1309.
72. Higgins JP, Thompson SG, Deeks JJ, et al. Measuring inconsistency in meta-analyses[J]. BMJ, 2003, 327(7414): 557-560.
73. Hernán MA, Hernández-Díaz S, Robins JM. A structural approach to selection bias[J]. Epidemiology, 2004, 15(5): 615-625.
74. Myburgh JA, Finfer S, Bellomo R, et al. Hydroxyethyl starch or saline for fluid resuscitation in intensive care[J]. N Engl J Med, 2012, 367(20): 1901-1911.
75. Prowle JR, Bellomo R. Fluid administration and the kidney[J]. Curr Opin Crit Care, 2010, 16(4): 332-336.
76. Egger M, Smith GD, Schneider M, et al. Bias in meta-analysis detected by a simple, graphical test[J]. BMJ, 1997, 315(7109): 629-634.
77. Shankar-Hari M, Phillips GS, Levy ML, et al. Developing a new definition and assessing new clinical criteria for septic shock: for the third international consensus definitions for sepsis and septic shock (Sepsis-3)[J]. JAMA, 2016, 315(8): 775-787.
78. Seymour CW, Liu VX, Iwashyna TJ, et al. Assessment of clinical criteria for sepsis: for the third international consensus definitions for sepsis and septic shock (Sepsis-3)[J]. JAMA, 2016, 315(8): 762-774.

Chinese Journal of Evidence-Based Medicine

Association between fluid balance at different time points and mortality in patients with septic shock: a meta-analysis

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