Both Positive and Negative Fluid Balance May Be Associated With Reduced Long-Term Survival in the Critically Ill

Objectives: Among critically ill patients with acute kidney injury, exposure to positive fluid balance, compared with negative fluid balance, has been associated with mortality and impaired renal recovery. However, it is unclear whether positive and negative fluid balances are associated with poor outcome compared to patients with even fluid balance (euvolemia). In this study, we examined the association between exposure to positive or negative fluid balance, compared with even fluid balance, on 1-year mortality and renal recovery. Design: Retrospective cohort study. Setting: Eight medical-surgical ICUs at the University of Pittsburgh Medical Center, Pittsburgh, PA. Patients: Critically ill patients admitted between July 2000 and October 2008. Interventions: None. Measurements and Main Results: Among 18,084 patients, fluid balance was categorized as negative (

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