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Association between fluid overload and delirium/coma in mechanically ventilated patients 大内, 玲 OUCHI, Akira オオウチ, アキラ SAKURAMOTO, Hideaki 櫻本, 秀明 サクラモト, ヒデアキ 星野, 晴彦 HOSHINO, Haruhiko ホシノ, ハルヒコ 松石, 雄二朗 MATSUISHI, Yujiro マツイシ, ユウジロウ SAKAGUCHI, Tatsuya サカグチ, タツヤ 榎本, 有希 ENOMOTO, Yuki エノモト, ユウキ 星野, 哲也 HOSHINO, Tetsuya ホシノ, テツヤ SIMOJO, Nobutake 下條, 信威 シモジョウ, ノブタケ 井上, 貴昭 INOUE, Yoshiaki イノウエ, ヨシアキ © 2020 The Authors. Acute Medicine & Surgery published by John Wiley & Sons Australia, Ltd on behalf of Japanese Association for Acute Medicine This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. brain dysfunction delirium fluid fluid overload intensive care application/pdf Aim Several studies have shown an association between fluid overload (FO) and mortality or duration of mechanical ventilation in critically ill patients. However, the association between FO and delirium duration remains unclear. Methods This retrospective observational cohort study was undertaken at University of Tsukuba Hospital (Tsukuba, Japan) from April 2015 to March 2017. Mechanically ventilated patients who stayed in the intensive care unit for more than 7 days were eligible for inclusion. Univariate analysis was carried out with the Mann–Whitney U-test for continuous variables and Fisher’s exact test for categorical variables. A multivariate proportional odds logistic regression model was used to evaluate the association between FO and delirium/coma days (DCDs) during the 7-day study period. Results A total of 118 patients were included and divided into FO and non-FO groups. Fluid overload occurred in 40% of patients. The FO group had a higher APACHE II score than the non-FO group (19 [16–26] versus 23 [20–29], P = 0.017). Cumulative fluid balance at day 3 was higher in the FO group (3,238 [281–6,530] versus 7,886 [4,106–10,631], P < 0.001). Delirium days within 7 days was longer in the FO group (1 [0–3] versus 2 [1–3], P = 0.048) and DCDs was longer in the FO group (4 [1–5] versus 6 [3–7], P = 0.002). After adjusting for covariates, there were significant associations between FO and DCDs (odds ratio, 2.16; 95% confidence interval, 1.05–4.47). Conclusions Our findings suggest that FO is associated with increased DCDs in mechanically ventilated patients. Japanese Association for Acute Medicine 日本救急医学会 2020-01 eng journal article VoR https://jrckicn.repo.nii.ac.jp/records/861 https://doi.org/10.1002/ams2.508 https://www.jaam.jp/ 日本救急医学会 https://doi.org/10.1002/ams2.508 Acute Medicine & Surgery (Wiley online library) 20528817 Acute Medicine & Surgery 7 1 e508