Fluid overload is common and is associated with substantial morbidity and mortality in critically ill children. Additional research should now ideally focus on interventions aimed to mitigate the potential for harm associated with fluid overload. This systematic review and meta-analysis of 44 studies including 7507 children showed strong and consistent evidence of an association between fluid overload and poor outcomes in critically ill children, including worsening respiratory function, development of acute kidney injury, longer pediatric intensive care stay, and death.

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