Methods: Retrospective, multicenter, cohort study of 255 patients with septic shock who were also HIV positive admitted to the intensive care units of 28 academic and community hospitals in three countries between 1996 and 2007. We used logistic regression to investigate the association between volume of fluid infused during the first 24 hours and ICU and 90-day survival, after adjustment for severity of illness (APACHE II score) and body weight (BMI).
Results: Total volume of fluid infused during the first 24 hours was not associated with ICU or 90-day survival (p=0.7 and p=0.9). However, volume of fluid infused before 6 hours was associated with increased ICU (OR=1.8, 95%Cl 3.3-0.97, p=0.06) and 90-day (OR=1.9, 95%CI 3.4-1.0, p=0.03) survival whereas volume of fluid infused between 6 and 24 hours was associated with decreased ICU (OR=0.60, 95%CI 0.39-0.99, p=0.05) and 90-day (OR=0.62, 95%CI 0.37-0.97, p=0.04) survival. Increased BMI was also associated with decreased ICU (OR=0.83, 95% CI0.69-0.99, p=0.04] and 90-day (OR=0.81, 95% CI 0.67-0.97, p=0.02) survival.
Conclusion: Amongst HIV positive patients admitted to the ICU for severe sepsis and septic shock quantity as well as timing are important determinants of survival.
J. J. Douglas,
K. R. Walley, None
P. M. Dodek, None
A. Kumar, None