Hourly Fluid Balance in Patients Receiving Continuous Renal Replacement Therapy.

INTRODUCTION

Little is known about early (first 48 h) hourly and cumulative fluid balance (FB) during continuous renal replacement therapy (CRRT).

OBJECTIVES

To study the characteristics and outcome associations of early hourly and cumulative FB.

METHODS

We studied FB in CRRT patients (2016-2018).

RESULTS

Among 350 patients, mean hourly FB became negative after 20 CRRT hours, but within 6 CRRT hours in patients with baseline fluid overload. A negative early FB was never achieved in patients receiving vasopressor therapy (p < 0.001). Mortality was 31%. The percentage of hourly negative FB was independently associated with decreased ICU mortality. A time-weighted hourly FB between 18.5 and -33 mL/h was also significantly and independently associated with decreased mortality.

CONCLUSIONS

In CRRT patients, an early FB conservative approach is possible, modulated by patient characteristics, and associated with a low mortality. Moreover, avoidance of an early positive FB is associated with decreased mortality.