<![CDATA[Introduction: Fluid balance is a critical component of intensive care unit (ICU) patient management, and both positive and negative imbalances are associated with increased morbidity and mortality. Evidence regarding the cumulative fluid balance in Indonesian ICUs remains limited. To determine the fluid balance profile of ICU patients and its relationship with patient outcome and length of stay Methods: A descriptive-analytical observational study with a cross-sectional design was conducted at the ICU of Haji Adam Malik Central General Hospital, Medan, from January to June 2025. Of 222 patients screened, 64 adults (≥18 years) treated for ≥24 h were selected by total sampling from medical records. Cumulative fluid balance was categorized as positive or negative, and bivariate associations with outcome and length of stay were assessed using the chi-square test (p<0.05). Results: The majority of patients (59.4%) had a negative cumulative fluid balance. Negative balance predominated among patients aged 25–65 years, males, those with medical admissions, and obese patients, whereas positive balance predominated among those aged >65 years, females, those with surgical admissions, and underweight patients. Fluid balance was significantly associated with patient outcomes (p=0.003) and length of stay (p=0.001). Negative balance was associated with survival (79.3%) and a stay >7 days (80.5%), whereas positive balance was more frequent among deceased patients (57.1%) and those staying 1–3 days (81.8%). Conclusion: Negative cumulative fluid balance predominated and was associated with survival and a longer ICU stay. Close monitoring and individualized fluid management are essential for optimizing patient outcomes.]]>
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