Emel UYAR, Ahmet Alptuğ GÜNGÖR, Oktay PERK, Serhan ÖZCAN, Esra KOÇKUZU, Serhat EMEKSİZ

Kritik Hasta Çocuklarda Sıvı Birikimi İkilemi, Retrospektif Bir Çalışma

Amaç: Çocuk yoğun bakım ünitelerinde (ÇYBÜ) hastalarda sıvı birikimi meydana gelmektedir. Çocuk yoğun bakım ünitelerinde uygulanan ilaçlar, hastalarda önemli kümülatif sıvı yüküne katkıda bulunabilir. Bu çalışmada akut böbrek yetmezliği (AKI) olmayan hastalarda sıvı birikimini araştırmayı ve ilaçların sıvı alımına katkısını belirlemeyi amaçladık. Gereç ve Yöntem: Bu çalışmada 101 hastaya ait 527 adet günlük takip formu geriye dönük olarak incelendi. Bulgular: Komorbiditesi olan, invaziv mekanik ventilasyon uygulanan ve inotrop ihtiyacı olan hastalarda toplam sıvı yükü daha yüksek bulundu. Sepsisli hastalarda sıvı yükü diğer tanı gruplarına göre daha yüksek iken, çocuklarda multisistem inflamatuar sendromlu hastalarda (MIS-C) anlamlı olarak daha düşüktü. Kümülatif sıvı yükü medyan (IQR) ilk 5 günde %11,6 (7,1-16,4) iken 10. günde medyan (IQR) %25,7'ye (14,65-34,1) ulaştı. Hastanın takip günleri arttıkça kümülatif sıvı yükü arttı. Tek başına ilaçlardan ortalama günlük sıvı alımı (IQR) %14,48 (8,07-24,13) idi. İlaçların toplam sıvı yüküne katkısı hastaların yaşı azaldıkça arttı (r: -0,164, p

Anahtar Kelimeler:

Çocuk yoğun bakım, sıvı birikimi, sıvı yükü, ilaç

Fluid Accumulation Dilemma in the Critically Ill Children, A Retrospective Study

Aim: Fluid accumulation occurs in pediatric patients in pediatric intensive care units (PICU). Medications administered in pediatric intensive care units can contribute to significant cumulative load in patients. In present study, we aimed to study fluid accumulation on patients without AKI and to determine contribution of medications over fluid intake. Material and Method: In this study, 527 daily follow-up forms of 101 patients was investigated retrospectively. Results: Total fluid load was found to be higher in patients with comorbidities, who underwent invasive mechanical ventilation, and who needed inotropes. While fluid load was higher in patients with sepsis than in other diagnostic groups, it was significantly lower in patients with multisystem inflammatory syndrome in children (MIS-C). While the median (IQR) of the cumulative fluid load was 11.6% (7.1-16.4) in the first 5 days, the median (IQR) reached 25.7% (14.65-34.1) on the 10th day. The cumulative fluid load increased as the patient's follow-up days increased. The median average daily fluid intake (IQR) from drugs alone was 14.48% (8.07-24.13). The contribution of drugs to the total fluid load increased as the age of patients decreased (r: -0.164, p

Keywords:

Pediatric intensive care, fluid accumulation, fluid load, medication,

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