Hubungan Akumulasi Balance Cairan dengan Morbiditas dan Mortalitas pada Pasien Sepsis yang Dirawat di Intensive Care Unit RSUP H Adam Malik Medan

Abstract

Introduction: Sepsis affects millions of people and is one of the leading causes of admission to intensive care units. Fluid therapy plays a crucial role in the management of sepsis; however, fluid accumulation remains a challenge that impacts the progression and prognosis of sepsis. Monitoring fluid balance is one way to prevent fluid accumulation in sepsis patients and can predict morbidity and mortality risk. Methods: This is a retrospective cohort study involving adult sepsis patients in the ICU. Patient identification data, length of ICU stay, incidence of AKI and ARDS, fluid balance over the first 72 hours of ICU treatment, and mortality rates were obtained from medical records. The relationships between variables were tested using the Kruskal Wallis test and the Mann Whitney test. Results: A total of 64 samples were included in the study, with a majority being male (57.8%) and aged between 46 59 years (56.25%). The fluid balance accumulation during the first 72 hours was divided into two groups: positive balance (850.45 [249.7 1299.6]) and negative balance 224.6 650 50.2)]). AKI and ARDS were observed in 56.25% and 85.9% of patients, respectively. Additionally, 85.9% of the samples were treated in the ICU for 0 14 days, with a mortality rate of 73.4%. A significant relationship was found between positive fluid balance accumulation and the incidence of AKI (p < 0.05), ARDS (p < 0.05), and mortality (p < 0.05); however, the relationship between fluid balance accumulation and length of ICU stay was not significant (p > 0.05). Conclusion: Fluid balance accumulation during the first 72 hours in ICU is associated with increased morbidity and mortality risk in sepsis.