This study was a restrictive observation study from the Medical Information Mart for Intensive Care IV (MIMIC-IV version 0.4) database from 2008 to 2019 [24 ]. An individual who has finished the Collaborative Institutional Training Initiative examination (Certification number 35931520 for author Zhou) can access the database. This is a longitudinal, single-center database including 257,366 individuals and 196,527 adults, and 11,263 patients with sepsis (Defined by sepsis-3 criteria [1 (link)]). In our study, we extracted patients’ parameters containing age, gender, ethnic group, admission type, insurance condition, the first 24-h Sequential Organ Failure Assessment (SOFA) score, Simplified Acute Physiology Score II (SAPS) score, mean arterial blood pressure (MAP), heart rate, respiratory rate, temperature, SpO2, total urine output during the first 24 h after ICU admission, lactate level, the use of vasopressors, weight, mechanical ventilation, renal replacement therapy (RRT), the stage of acute kidney injury (AKI), anamnesis (myocardial infarction, cancer, renal disease, cirrhosis and diabetes) and the type and volume of their fluid administration during the whole ICU stay. Vasopressors included norepinephrine, phenylephrine, epinephrine, vasopressin, dopamine, and dobutamine. For the antibiotics, Carbapenems (meropenem), Glycopeptide (vancomycin), β-lactams (ceftriaxone, cefotaxime, and cefepime), and Aminoglycosides (gentamicin and amikacin) were extracted into our analysis. In this study, types of administration for crystalloids and albumin including normal saline and lactated Ringer’s (LR) solution, while 5% and 25% HSA for colloids. The code of data extraction is available on Github (https://github.com/MIT-LCP/mimic-iv).
Adults patients (≥ 18 years) with sepsis and complete fluid administration records were screened in the analysis. The following exclusion criteria were used: (1) patients who have not received any crystalloids administration; (2) patients who received albumin longer than 24 h after the initiation of crystalloids administration or preceded the crystalloids. For patients who had ICU admission more than once, only data of the first ICU admission of the first hospital stay were included.
Free full text: Click here