{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T16:53:58Z","timestamp":1792601638539,"version":"4.5.0"},"reference-count":33,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,2,1]],"date-time":"2023-02-01T00:00:00Z","timestamp":1675209600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002858","name":"China Postdoctoral Science Foundation","doi-asserted-by":"publisher","award":["2018T111159"],"award-info":[{"award-number":["2018T111159"]}],"id":[{"id":"10.13039\/501100002858","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>While many factors that are associated with increased mortality in septic shock patients have been identified, the effects of serum osmolarity on the outcomes of ICU patients with septic shock have not yet been studied.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      The present study was designed to examine the association of serum osmolarity with ICU 28-day mortality in ICU patients with septic shock. Adult patients diagnosed with septic shock from the MIMIC-IV database were selected in this study. The serum osmolarity was calculated synchronously according to the serum concentrations of Na\n                      <jats:sup>+<\/jats:sup>\n                      , K\n                      <jats:sup>+<\/jats:sup>\n                      , glucose, and urea nitrogen.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In the present study, a significant difference was observed between the 28-day mortality of septic shock patients with hypo-osmolarity, hyper-osmolarity, and normal osmolarity (30.8%, 34.9%, and 23.0%, respectively,\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.001), which were detected at ICU admission. After propensity score matching (PSM) for basic characteristics, the relatively higher mortality was still observed in the hypo-osmolarity and hyper-osmolarity groups, compared to normal osmolarity group (30.6%, 30.0% vs. 21.7%,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.009). Furthermore, we found that transforming the hyper-osmolarity into normal osmolarity by fluid therapy on day 2 and 3 decreased this mortality.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The serum osmolarity disorder is markedly associated with increased 28-day mortality in septic shock patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2023.1083769","type":"journal-article","created":{"date-parts":[[2023,2,1]],"date-time":"2023-02-01T00:05:13Z","timestamp":1675209913000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":12,"title":["Increased ICU mortality in septic shock patients with hypo- or hyper- serum osmolarity: A retrospective study"],"prefix":"10.3389","volume":"10","author":[{"given":"Gang","family":"Heng","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiasi","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Dong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiankun","family":"Jia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benqi","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanbing","family":"Shen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhen","family":"Lan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianxin","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tao","family":"Fu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weidong","family":"Jin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,2,1]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"75","DOI":"10.1016\/S0140-6736(18)30696-2","article-title":"Sepsis and septic shock.","volume":"392","author":"Cecconi","year":"2018","journal-title":"Lancet."},{"key":"B2","doi-asserted-by":"crossref","first-page":"304","DOI":"10.1007\/s00134-017-4683-6","article-title":"Surviving sepsis campaign: international guidelines for management of sepsis and septic shock: 2016.","volume":"43","author":"Rhodes","year":"2017","journal-title":"Intensive Care Med."},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-019-2478-6","article-title":"Frequency and mortality of septic shock in Europe and North America: a systematic review and meta-analysis.","volume":"23","author":"Vincent","year":"2019","journal-title":"Crit Care."},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1186\/s13613-021-00830-8","article-title":"Early combination of albumin with crystalloids administration might be beneficial for the survival of septic patients: a retrospective analysis from MIMIC-IV database.","volume":"11","author":"Zhou","year":"2021","journal-title":"Ann Intensive Care."},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-020-03109-9","article-title":"Central venous pressure measurement is associated with improved outcomes in septic patients: an analysis of the MIMIC-III database.","volume":"24","author":"Chen","year":"2020","journal-title":"Crit Care."},{"key":"B6","doi-asserted-by":"crossref","first-page":"R116","DOI":"10.1186\/cc2373","article-title":"Assessment of six mortality prediction models in patients admitted with severe sepsis and septic shock to the intensive care unit: a prospective cohort study.","volume":"7","author":"Arabi","year":"2003","journal-title":"Crit Care."},{"key":"B7","doi-asserted-by":"publisher","first-page":"370","DOI":"10.5114\/ait.2019.88184","article-title":"Septic shock patients admitted to the intensive care unit with higher SOFA score tend to have higher incidence of abdominal compartment syndrome\u2013a preliminary analysis.","volume":"51","author":"Pereira","year":"2019","journal-title":"Anaesthesiol Intensive Ther."},{"key":"B8","doi-asserted-by":"publisher","first-page":"102","DOI":"10.1056\/NEJM198401123100207","article-title":"Current concepts. 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