title: Fluid overload in a South African pediatric intensive care unit.
abstract: OBJECTIVE
  Fluid resuscitation is integral to resuscitation guidelines and critical care. However, fluid overload (FO) yields increased morbidity.
  
  
  METHODS
  Prospective observational study of Red Cross War Memorial Children's Hospital pediatric intensive care unit admissions (February to March 2013). FO % = (fluid in minus fluid out) [liters]/weight [kg] × 100%.
  
  
  METHODS
  FO ≥ 10%, 28 day mortality.
  
  
  RESULTS
  Median [interquartile range (IQR)] age: 9.5 (2.0-39.0) months, median (IQR) admission weight: 7.9 (3.6-13.7) kg. Median (IQR) FO with admission weight: 3.5 (2.1-4.9)%; three patients had FO ≥ 10%. The 28 day mortality was 10% (n = 10). Patients who died had higher mean (IQR) FO using admission weight [4.9 (2.9-9.3)% vs. 3.4 (1.9-4.8)%; p = 0.04].
  
  
  CONCLUSIONS
  Low FO ≥ 10% prevalence with 28 day mortality 10%. Higher FO% with admission weight associated with mortality (p = 0.04). We advocate further investigation of FO% as a simple bedside tool.
authors.affiliation: Division of Intensive Care and Pediatric Surgery, Department of Pediatrics, Intensive Care Unit, Erasmus Medical Center, Sophia Children's Hospital, Rotterdam, 3015GJ, The Netherlands n.ketharanathan@gmail.com.
authors.forename: Naomi
authors.initials: N
authors.lastname: Ketharanathan
authors.affiliation: Division of Pediatric Critical Care and Children's Heart Disease, Department of Pediatric Medicine, University of Cape Town and Red Cross War Memorial Children's Hospital, Cape Town 7700, South Africa.
authors.forename: Mignon
authors.initials: M
authors.lastname: McCulloch
authors.affiliation: Department of Pediatrics, Wellcome Centre for Clinical Tropical Medicine, Wright-Fleming Institute, St. Mary's Campus, Imperial College, London, W2 1PG, Great Britain.
authors.forename: Clare
authors.initials: C
authors.lastname: Wilson
authors.affiliation: Division of Pediatric Critical Care and Children's Heart Disease, Department of Pediatric Medicine, University of Cape Town and Red Cross War Memorial Children's Hospital, Cape Town 7700, South Africa.
authors.forename: Beyra
authors.initials: B
authors.lastname: Rossouw
authors.affiliation: Division of Pediatric Critical Care and Children's Heart Disease, Department of Pediatric Medicine, University of Cape Town and Red Cross War Memorial Children's Hospital, Cape Town 7700, South Africa.
authors.forename: Shamiel
authors.initials: S
authors.lastname: Salie
authors.affiliation: Division of Pediatric Critical Care and Children's Heart Disease, Department of Pediatric Medicine, University of Cape Town and Red Cross War Memorial Children's Hospital, Cape Town 7700, South Africa.
authors.forename: Johan
authors.initials: J
authors.lastname: Ahrens
authors.affiliation: Division of Pediatric Critical Care and Children's Heart Disease, Department of Pediatric Medicine, University of Cape Town and Red Cross War Memorial Children's Hospital, Cape Town 7700, South Africa.
authors.forename: Brenda M
authors.initials: BM
authors.lastname: Morrow
authors.affiliation: Division of Pediatric Critical Care and Children's Heart Disease, Department of Pediatric Medicine, University of Cape Town and Red Cross War Memorial Children's Hospital, Cape Town 7700, South Africa.
authors.forename: Andrew C
authors.initials: AC
authors.lastname: Argent
mesh_terms: D001826:Body Fluids; D002675:Child, Preschool; D016638:Critical Illness; D005260:Female; D005440:Fluid Therapy / Q000009:adverse effects* / Q000401:mortality; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D015278:Intensive Care Units, Pediatric; D007902:Length of Stay; D008297:Male; D009017:Morbidity; D015995:Prevalence; D011446:Prospective Studies; D012151:Resuscitation / Q000379:methods*; D012307:Risk Factors; D013019:South Africa; D016896:Treatment Outcome; D014883:Water-Electrolyte Imbalance / Q000097:blood / Q000209:etiology* / Q000628:therapy
keywords: critical care; fluid overload; morbidity; mortality; pediatric