The effect of fluid therapy on the clinical outcome of patients with chronic obstructive pulmonary disease in the emergency department

Abstract Background Chronic obstructive pulmonary disease (COPD) is a progressive and preventable condition often requiring emergency and intensive care interventions during exacerbations. Aimof work In this study, we aimed to investigate the effect of fluid therapy administered to patients admitted to the intensive care unit from the emergency department due to COPD on mortality and readmission rates. In this study, we aimed to investigate the effect of fluid therapy administered to patients admitted to intensive care from the emergency department due to COPD on mortality and readmission rates. Subjects and methods This was a retrospective single-center study. This study included data from 162 patients hospitalized between 2014 and 2018 with established COPD diagnoses who were admitted to the Pulmonary Intensive Care Unit after presenting to the Emergency Department with characteristic COPD manifestations, primarily dyspnea. Patient recruitment and data collection were conducted in accordance with predetermined inclusion criteria, focusing on confirmed COPD cases that required intensive care management. Result Patients with poor clinical outcomes ( n = 61, 37.7%) were found to have higher respiratory and pulse rates, longer hospital stays, and elevated fluid balance during the first 4 days of ICU admission ( p < 0.05). This study emphasizes the significant association between positive fluid balance and poor outcomes, particularly on days 1–4. For instance, the median fluid balance on day 1 was 550 mL (IQR 125.0–1040.0) in patients with poor outcomes, compared to 200 mL (IQR − 300.0–670.0) in those with favorable outcomes ( p = 0.003). Pulmonary congestion on chest X-rays at admission was also linked to worse outcomes ( p < 0.001). While patients with COPD often require fluid therapy to maintain hemodynamic stability, excessive fluid retention can worsen prognosis, as demonstrated by the higher mortality and readmission rates observed in this study. These findings align with previous research showing that a positive fluid balance correlates with increased mortality in ICU patients. Conclusion Careful management of fluid therapy is crucial for patients with COPD admitted to the ICUs. Clinicians should aim to avoid excessive fluid retention, particularly during the initial days of hospitalization, to improve clinical outcomes.