Abstract

COPANA OLMOS, Raul  and  DIAZ VILLALOBOS, Willmer. Fluid overload index in children with severe sepsis and septic shock . Gac Med Bol [online]. 2019, vol.42, n.1, pp.11-16. ISSN 1012-2966.

Fluid therapy is one pillar of the treatment of septic shock, however, a hydric ≥ 10% of the weight or Index of Water Overload (ISCH> 10%) is associated with poor hospital outcomes. Objective: the present study aims to determine the ISCH in patients with septic shock, and its main associations in terms of mortality and morbidity. Methods: an observational and descriptive study was conducted in 49 children hospitalized with septic shock in the UTIP of the HNMAV; The patients were divided into two groups according to the ISCH> 10% (22 patients) and <10% (18 patients), for their descriptive analysis we included comparison of means and calculation of the OR. Results: regarding the water requirements we observed that the group with ISCH> 10% a mean of 5681ml; while in the group with ISCH <10% the mean was 3297.8ml (p= 0.19), showing greater overload with the administration of colloids and blood products (p = 0.02, p = 0.004). Regarding hospital outcomes, was found morbidity associated with ISCH > 10% (respiratory dysfunction, vasopressor requirement and renal replacement therapy); The length of hospitalization and UTIP were not different in groups (p = 0.6), but there was higher mortality of patients with SSI> 10% (p = 0.01, OR: 5.57 IC95% 1.4-21.8). Conclusions: fluids therapy of in the patient with septic shock constitutes one of the first-line hemodynamic treatments, however in limited resources settings, overload should be avoided, mainly due to associated morbidity during the first 72 hours.

Keywords : water overload index; sepsis; septic shock; fluid therapy.

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