TY - JOUR
T1 - Mortality and hyperchloremia in the intensive care unit
AU - Medina-Lombo, Ronald Antonio
AU - Sánchez-García, Víctor Leonardo
AU - Gómez-Gómez, Luisa Fernanda
AU - Vidal-Bonilla, Silvio Andrés
AU - Castro-Castro, Juan José
AU - Sánchez-Vanegas, Guillermo
N1 - Publisher Copyright:
Copyright © 2018 Sociedad Colombiana de Anestesiología y Reanimación (S.C.A.R.E.)
PY - 2018/9
Y1 - 2018/9
N2 - Introduction: Administrating intravenous fluids is one of the most frequent practices in the care of critically ill patients, since most of them present shock or hypotension from any cause. The rapid and aggressive administration of these fluids may lead to adverse results, including acute renal failure and hydroelectrolytic disorders which are highly associated with fatal outcomes. Objectives: To establish the association between hyperchloremia and mortality in patients admitted to the intensive care unit (ICU) of Hospital Universitario de San José between August 2013 and January 2017, in addition to their demographic characteristics, the incidence of chloride abnormalities, and its association to renal failure. Methods: Analytic retrospective cohort study in the adult ICU at the Hospital Universitario de San José from August 1, 2013 to January 31, 2017. Results: A total of 839 patients were evaluated, 210 exposed and 629 not exposed. The relative risk of death for those who developed hyperchloremia was 3.12 (95% confidence interval [CI] 2.16–4.49) (P<0.001). The multivariate analysis generated an hazard ratio of 2.31 (95% CI 1.47–3.63) adjusted for age, sex, APACHE II at admission, sepsis, neurocritical state, and development of renal failure. Conclusion: Hyperchloremia is a frequent event in patients in the ICU; it may act as an independent variable for mortality in critical patients.
AB - Introduction: Administrating intravenous fluids is one of the most frequent practices in the care of critically ill patients, since most of them present shock or hypotension from any cause. The rapid and aggressive administration of these fluids may lead to adverse results, including acute renal failure and hydroelectrolytic disorders which are highly associated with fatal outcomes. Objectives: To establish the association between hyperchloremia and mortality in patients admitted to the intensive care unit (ICU) of Hospital Universitario de San José between August 2013 and January 2017, in addition to their demographic characteristics, the incidence of chloride abnormalities, and its association to renal failure. Methods: Analytic retrospective cohort study in the adult ICU at the Hospital Universitario de San José from August 1, 2013 to January 31, 2017. Results: A total of 839 patients were evaluated, 210 exposed and 629 not exposed. The relative risk of death for those who developed hyperchloremia was 3.12 (95% confidence interval [CI] 2.16–4.49) (P<0.001). The multivariate analysis generated an hazard ratio of 2.31 (95% CI 1.47–3.63) adjusted for age, sex, APACHE II at admission, sepsis, neurocritical state, and development of renal failure. Conclusion: Hyperchloremia is a frequent event in patients in the ICU; it may act as an independent variable for mortality in critical patients.
KW - Blood-Derivative Drugs
KW - Critical Care
KW - Hypovolemia
KW - Kidney Diseases
KW - Mortality
UR - http://www.scopus.com/inward/record.url?scp=85054700776&partnerID=8YFLogxK
U2 - 10.1097/CJ9.0000000000000069
DO - 10.1097/CJ9.0000000000000069
M3 - Artículo
AN - SCOPUS:85054700776
SN - 2256-2087
VL - 46
SP - 216
EP - 221
JO - Colombian Journal of Anesthesiology
JF - Colombian Journal of Anesthesiology
IS - 3
ER -