{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T17:19:21Z","timestamp":1788887961942,"version":"build-2803163510"},"reference-count":79,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2022,1,11]],"date-time":"2022-01-11T00:00:00Z","timestamp":1641859200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: The detrimental impact of fluid overload (FO) on intensive care unit (ICU) morbidity and mortality is well known. However, research to identify subgroups of patients particularly prone to fluid overload is scarce. The aim of this cohort study was to derive \u201cFO phenotypes\u201d in the critically ill by using machine learning techniques. Methods: Retrospective single center study including adult intensive care patients with a length of stay of \u22653 days and sufficient data to compute FO. Data was analyzed by multivariable logistic regression, fast and frugal trees (FFT), classification decision trees (DT), and a random forest (RF) model. Results: Out of 1772 included patients, 387 (21.8%) met the FO definition. The random forest model had the highest area under the curve (AUC) (0.84, 95% CI 0.79\u20130.86), followed by multivariable logistic regression (0.81, 95% CI 0.77\u20130.86), FFT (0.75, 95% CI 0.69\u20130.79) and DT (0.73, 95% CI 0.68\u20130.78) to predict FO. The most important predictors identified in all models were lactate and bicarbonate at admission and postsurgical ICU admission. Sepsis\/septic shock was identified as a risk factor in the MV and RF analysis. Conclusion: The FO phenotypes consist of patients admitted after surgery or with sepsis\/septic shock with high lactate and low bicarbonate.<\/jats:p>","DOI":"10.3390\/jcm11020336","type":"journal-article","created":{"date-parts":[[2022,1,11]],"date-time":"2022-01-11T14:05:07Z","timestamp":1641909907000},"page":"336","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":30,"title":["Fluid Overload Phenotypes in Critical Illness\u2014A Machine Learning Approach"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3206-9112","authenticated-orcid":false,"given":"Anna S.","family":"Messmer","sequence":"first","affiliation":[{"name":"Department of Intensive Care Medicine, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michel","family":"Moser","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Medicine, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0331-4577","authenticated-orcid":false,"given":"Patrick","family":"Zuercher","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Medicine, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9162-5724","authenticated-orcid":false,"given":"Joerg C.","family":"Schefold","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Medicine, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4067-7174","authenticated-orcid":false,"given":"Martin","family":"M\u00fcller","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen A.","family":"Pfortmueller","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Medicine, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,1,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1016\/j.kint.2018.11.047","article-title":"Fluid management in the critically ill","volume":"96","author":"Vincent","year":"2019","journal-title":"Kidney Int."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"541","DOI":"10.1038\/s41581-018-0044-0","article-title":"Intravenous fluid therapy in critically ill adults","volume":"14","author":"Finfer","year":"2018","journal-title":"Nat. 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