Source: Annual Congress 2010 - Acute respiratory failure
Disease area: Respiratory critical care

Abstract

Background: Fluid balance affects lung mechanic and outcome in critically ill patients. We studied effect of fluid balance on oxygen exchange by assessing alveolar-arterial oxygen gradient (PA-a O₂) in mechanically ventilated patients.
Material and Methods: This retrospective study performed in patients who were admitted in medical and surgical ICUs of Sari Imam Hospital, Mazandaran University of medical sciences, from 2003 to 2009. Daily fluid balance measured by input minus output. 30 patients with positive fluid balance (PFB) and 30 subjects with negative fluid balance (NFB) during 4 consecutive days were enrolled in this study. PA-a O₂ were calculated in these two groups.
Findings: The mean (±SD) age in PFB group was 48.9±21.2 (19 male, 11 female) and NFB group 37.1±15.7 (25 male, 5 female). The 24h, 48h, and 96h balances were 1226^cc±881, 1311^cc±751, and 957^cc±661 in PFB group and -1122^cc±692, -920^cc±394, and -1164^cc±695 in NFB group. The mean differences (±SD) of PA-a O₂ in 24h, 48h, and 96h versus the first admission day were 11.3±39.2, 1.69±51.1, and -1.50±64 in PFB subjects and -21.8±60.8, -27.8±84.9, and -19.3±68.7 in NFB patients. Only in the first day it was statistically significant (P = 0.015). Mortality was significantly higher in PFB patients (P<0.0001).
Conclusion: Positive fluid balance has no significant effect on PA-a O₂ but could be used as a independent predictor of mortality.

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Citations should be made in the following way:
M. Aliyali, A. Sharifpoor, R. Tavakoli (Sari, Islamic Republic Of Iran). Effect of fluid balance on alveolar-arterial oxygen gradient in mechanically ventilated patients. Eur Respir J 2010; 36: Suppl. 54, 2293

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