Respiratory failure & ventilation
Spontaneous diuresis as a marker of successful liberation from positive pressure ventilation: A retrospective observational study
Authors' conclusion
PPVdc was associated with prompt and sustained increase in UO and a concomitant rise in MAP. Greater diuresis was linked to successful liberation from PPV, suggesting that mobilization of retained fluid is a marker of recovery, and the lack of it may help identify patients at higher risk of PPVdc failure.
Study context
- Population
- Adult ICU patients undergoing planned PPV discontinuation, excluding those receiving dialysis or IV furosemide within ±24 h of planned PPV discontinuation (PPVdc)587 (85 %) successful PPVdc
- Participants
- 687 patients
- Exposure
- Successful vs failed PPV discontinuation
- Successful PPVdcn = 587
- Outcome
- Change in urine output (UO) and MAP after PPVdc
Methodological detailspropensity score-matched analysis
- Propensity score-matched analysis
Main finding
As reported in the abstract
Mean hourly UO, whole cohort · 6 h after vs before PPVdc
- Mean hourly urine output (UO) 6 h after PPVdc, mL/h (mean ± SD)
- 118.2 ± 76.8
- Mean hourly UO before PPVdc (6 h comparison), mL/h
- 85.7 ± 48.1
- P, 6 h
- p < 0.01
- Mean hourly UO 24 h after PPVdc, mL/h (mean ± SD)
- 108.9 ± 54.7
- Mean hourly UO before PPVdc (24 h comparison), mL/h
- 87.5 ± 43.0
- P, 24 h
- p < 0.01
Observational data: associations, not effects.
Further findings
| Outcome | Adjusted difference (mL/h) (95 % CI) | P value |
|---|---|---|
| UO increase, successful vs failed PPVdc · 6 hConfirmed by propensity score-matched analysis | +18.8 (+4.5 to +33.1) | P = 0.01 |
Mean arterial pressure (MAP), whole cohort · 6 h and 24 h after PPVdc
- MAP rose concurrently by 8-10 %
- P < 0.01
Original publication
Spontaneous diuresis as a marker of successful liberation from positive pressure ventilation: A retrospective observational study. J Crit Care. Published 17 November 2025. doi:10.
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