Increased incidence of diuretic use in critically ill obese patients
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Mark_Increased incidence.pdf
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Author(s)
de Louw, Emma J.
Sun, Pepijn O.
Lee, Joon
Feng, Mengling
Mark, Roger G.
Celi, Leo Anthony G.
Mukamal, Kenneth J.
Danziger, John
Date Issued
June 2015
Journal
Journal of Critical Care
Publisher
Elsevier
Citation
De Louw, Emma J., Pepijn O. Sun, Joon Lee, Mengling Feng, Roger G. Mark, Leo Anthony Celi, Kenneth J. Mukamal, and John Danziger. “Increased Incidence of Diuretic Use in Critically Ill Obese Patients.” Journal of Critical Care 30, no. 3 (June 2015): 619–623.
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Author's final manuscript
Abstract
Objective—Sodium retention occurs commonly in cardiac and liver disease, requiring the administration of diuretics to restore fluid balance. Whether obesity is associated with sodium retention has not been fully evaluated.
Methods—In a large single-center cohort of critically ill patients, we evaluated whether admission body mass index was associated with the administration of either oral or intravenous diuretics during the intensive care unit (ICU) stay.
Main results—Of 7724 critically ill patients, 3946 (51.1%) were prescribed diuretics during the ICU stay. Overweight, class I obesity, and class II/III obesity were associated with a 1.35 (95% confidence interval [CI], 1.20–1.53; P < .001), 1.56 (95% CI, 1.35–1.80; P < .001), and 1.91 (95% CI, 1.61–2.26; P < .001) adjusted risk of receiving diuretics within the ICU, respectively. In adjusted analysis, a 5-kg/m2 increment of body mass index was associated with a 1.19 (95% CI, 1.14–1.23; P < .001) increased adjusted risk of within-ICU diuretics. Among those patients receiving loop diuretics, obese patients received significantly larger daily diuretic doses.
Conclusion—Critically ill obese patients are more likely to receive diuretics during their stay in the ICU and to receive higher dosages of diuretics. Our data suggest that obesity is an independent risk factor for sodium retention.
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available in PMC 2015 October 29
MIT Department
Massachusetts Institute of Technology. Institute for Medical Engineering & Science
Harvard University--MIT Division of Health Sciences and Technology
Massachusetts Institute of Technology. Institute for Medical Engineering & Science
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DOI of Published Version
https://doi.org/10.1016/j.jcrc.2015.01.023
