Examination of the association of steroids with fluid accumulation in critically ill patients, considering the possibility of biases

Abstract Glucocorticoids might have significant influence on positive fluid balance, mostly due to their mineralocorticoid effect. We assessed the association between glucocorticoid therapy and fluid balance in septic patients, in the intensive care unit (ICU). We considered two definitions of expos...

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Autores principales:	Amit Frenkel, Ran Abuhasira, Yoav Bichovsky, Anton Bukhin, Victor Novack, Evgeni Brotfain, Alexander Zlotnik, Moti Klein
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/1bb7e8111bd34164b286c73af79117a8
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spelling	oai:doaj.org-article:1bb7e8111bd34164b286c73af79117a82021-12-02T13:30:51ZExamination of the association of steroids with fluid accumulation in critically ill patients, considering the possibility of biases10.1038/s41598-021-85172-y2045-2322https://doaj.org/article/1bb7e8111bd34164b286c73af79117a82021-03-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-85172-yhttps://doaj.org/toc/2045-2322Abstract Glucocorticoids might have significant influence on positive fluid balance, mostly due to their mineralocorticoid effect. We assessed the association between glucocorticoid therapy and fluid balance in septic patients, in the intensive care unit (ICU). We considered two definitions of exposure: daily exposure to glucocorticoids and glucocorticoid treatment at any time. Of 945 patients, 375 were treated with glucocorticoids in the ICU. We applied four regression models. In the first, fluid balance did not differ during days with and without glucocorticoid treatment, among patients treated and not treated with glucocorticoids in the ICU. In our second model, daily fluid balance was increased in patients who were ever treated with glucocorticoids during their ICU stay compared to untreated patients. In the third model, which included only patients treated with glucocorticoids during their ICU stay, glucocorticoid treatment days were not associated with daily fluid balance. In the last model, on "steroid-free days", patients who received glucocorticoid treatment during their ICU stay had a positive fluid balance compared to those who were never treated with steroids. Despite their known mineralocorticoid activity, glucocorticoids themselves appear not to contribute substantially to fluid retention. This work highlights the importance of precise selection of variables to mitigate biases.Amit FrenkelRan AbuhasiraYoav BichovskyAnton BukhinVictor NovackEvgeni BrotfainAlexander ZlotnikMoti KleinNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Amit Frenkel Ran Abuhasira Yoav Bichovsky Anton Bukhin Victor Novack Evgeni Brotfain Alexander Zlotnik Moti Klein Examination of the association of steroids with fluid accumulation in critically ill patients, considering the possibility of biases
description	Abstract Glucocorticoids might have significant influence on positive fluid balance, mostly due to their mineralocorticoid effect. We assessed the association between glucocorticoid therapy and fluid balance in septic patients, in the intensive care unit (ICU). We considered two definitions of exposure: daily exposure to glucocorticoids and glucocorticoid treatment at any time. Of 945 patients, 375 were treated with glucocorticoids in the ICU. We applied four regression models. In the first, fluid balance did not differ during days with and without glucocorticoid treatment, among patients treated and not treated with glucocorticoids in the ICU. In our second model, daily fluid balance was increased in patients who were ever treated with glucocorticoids during their ICU stay compared to untreated patients. In the third model, which included only patients treated with glucocorticoids during their ICU stay, glucocorticoid treatment days were not associated with daily fluid balance. In the last model, on "steroid-free days", patients who received glucocorticoid treatment during their ICU stay had a positive fluid balance compared to those who were never treated with steroids. Despite their known mineralocorticoid activity, glucocorticoids themselves appear not to contribute substantially to fluid retention. This work highlights the importance of precise selection of variables to mitigate biases.
format	article
author	Amit Frenkel Ran Abuhasira Yoav Bichovsky Anton Bukhin Victor Novack Evgeni Brotfain Alexander Zlotnik Moti Klein
author_facet	Amit Frenkel Ran Abuhasira Yoav Bichovsky Anton Bukhin Victor Novack Evgeni Brotfain Alexander Zlotnik Moti Klein
author_sort	Amit Frenkel
title	Examination of the association of steroids with fluid accumulation in critically ill patients, considering the possibility of biases
title_short	Examination of the association of steroids with fluid accumulation in critically ill patients, considering the possibility of biases
title_full	Examination of the association of steroids with fluid accumulation in critically ill patients, considering the possibility of biases
title_fullStr	Examination of the association of steroids with fluid accumulation in critically ill patients, considering the possibility of biases
title_full_unstemmed	Examination of the association of steroids with fluid accumulation in critically ill patients, considering the possibility of biases
title_sort	examination of the association of steroids with fluid accumulation in critically ill patients, considering the possibility of biases
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/1bb7e8111bd34164b286c73af79117a8
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Examination of the association of steroids with fluid accumulation in critically ill patients, considering the possibility of biases

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