The impact of fluid balance on outcomes in critically ill near-term/term neonates: a report from the AWAKEN study group.
Acute Kidney Injury
/ diagnosis
Adult
Birth Weight
Critical Illness
Female
Gestational Age
Hospital Mortality
Humans
India
Infant, Newborn
Infant, Premature
Intensive Care Units, Neonatal
Male
North America
Premature Birth
Respiration, Artificial
Retrospective Studies
Risk Factors
Term Birth
Time Factors
Treatment Outcome
Water-Electrolyte Balance
Water-Electrolyte Imbalance
/ diagnosis
Weight Gain
Young Adult
Journal
Pediatric research
ISSN: 1530-0447
Titre abrégé: Pediatr Res
Pays: United States
ID NLM: 0100714
Informations de publication
Date de publication:
01 2019
01 2019
Historique:
received:
03
04
2018
accepted:
23
07
2018
revised:
17
07
2018
pubmed:
22
9
2018
medline:
13
3
2020
entrez:
22
9
2018
Statut:
ppublish
Résumé
In sick neonates admitted to the NICU, improper fluid balance can lead to fluid overload. We report the impact of fluid balance in the first postnatal week on outcomes in critically ill near-term/term neonates. This analysis includes infants ≥36 weeks gestational age from the Assessment of Worldwide Acute Kidney injury Epidemiology in Neonates (AWAKEN) study (N = 645). Fluid balance: percent weight change from birthweight. mechanical ventilation (MV) on postnatal day 7. The median peak fluid balance was 1.0% (IQR: -0.5, 4.6) and occurred on postnatal day 3 (IQR: 1, 5). Nine percent required MV at postnatal day 7. Multivariable models showed the peak fluid balance (aOR 1.12, 95%CI 1.08-1.17), lowest fluid balance in 1st postnatal week (aOR 1.14, 95%CI 1.07-1.22), fluid balance on postnatal day 7 (aOR 1.12, 95%CI 1.07-1.17), and negative fluid balance at postnatal day 7 (aOR 0.3, 95%CI 0.16-0.67) were independently associated with MV on postnatal day 7. We describe the impact of fluid balance in critically ill near-term/term neonates over the first postnatal week. Higher peak fluid balance during the first postnatal week and higher fluid balance on postnatal day 7 were independently associated with MV at postnatal day 7.
Sections du résumé
BACKGROUND
In sick neonates admitted to the NICU, improper fluid balance can lead to fluid overload. We report the impact of fluid balance in the first postnatal week on outcomes in critically ill near-term/term neonates.
METHODS
This analysis includes infants ≥36 weeks gestational age from the Assessment of Worldwide Acute Kidney injury Epidemiology in Neonates (AWAKEN) study (N = 645). Fluid balance: percent weight change from birthweight.
PRIMARY OUTCOME
mechanical ventilation (MV) on postnatal day 7.
RESULTS
The median peak fluid balance was 1.0% (IQR: -0.5, 4.6) and occurred on postnatal day 3 (IQR: 1, 5). Nine percent required MV at postnatal day 7. Multivariable models showed the peak fluid balance (aOR 1.12, 95%CI 1.08-1.17), lowest fluid balance in 1st postnatal week (aOR 1.14, 95%CI 1.07-1.22), fluid balance on postnatal day 7 (aOR 1.12, 95%CI 1.07-1.17), and negative fluid balance at postnatal day 7 (aOR 0.3, 95%CI 0.16-0.67) were independently associated with MV on postnatal day 7.
CONCLUSIONS
We describe the impact of fluid balance in critically ill near-term/term neonates over the first postnatal week. Higher peak fluid balance during the first postnatal week and higher fluid balance on postnatal day 7 were independently associated with MV at postnatal day 7.
Identifiants
pubmed: 30237572
doi: 10.1038/s41390-018-0183-9
pii: 10.1038/s41390-018-0183-9
pmc: PMC6941736
mid: NIHMS1061448
doi:
Types de publication
Journal Article
Multicenter Study
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
79-85Subventions
Organisme : NCATS NIH HHS
ID : UL1 TR003096
Pays : United States
Organisme : NCATS NIH HHS
ID : U54 TR001356
Pays : United States
Organisme : NIDDK NIH HHS
ID : R01 DK049419
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR001417
Pays : United States
Organisme : NHLBI NIH HHS
ID : R01 HL102497
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR001449
Pays : United States
Investigateurs
Sunny Juul
(S)
Namasivayam Ambalavanan
(N)
Subrata Sarkar
(S)
Alison Kent
(A)
Jeffery Fletcher
(J)
Carolyn L Abitbol
(CL)
Marissa DeFreitas
(M)
Shahnaz Duara
(S)
Jennifer R Charlton
(JR)
Jonathan R Swanson
(JR)
Carl D'Angio
(C)
Ayesa Mian
(A)
Erin Rademacher
(E)
Maroun J Mhanna
(MJ)
Rupesh Raina
(R)
Deepak Kumar
(D)
Jennifer G Jetton
(JG)
Patrick D Brophy
(PD)
Tarah T Colaizy
(TT)
Jonathan M Klein
(JM)
Christopher J Rhee
(CJ)
Juan C Kupferman
(JC)
Alok Bhutada
(A)
Shantanu Rastogi
(S)
Susan Ingraham
(S)
F Sessions Cole
(FS)
T Keefe Davis
(TK)
Lawrence Milner
(L)
Alexandra Smith
(A)
Mamta Fuloria
(M)
Frederick J Kaskel
(FJ)
Danielle E Soranno
(DE)
Jason Gien
(J)
Aftab S Chishti
(AS)
Sangeeta Hingorani
(S)
Michelle Starr
(M)
Craig S Wong
(CS)
Tara DuPont
(T)
Robin Ohls
(R)
Surender Khokhar
(S)
Sofia Perazzo
(S)
Patricio E Ray
(PE)
Mary Revenis
(M)
Sidharth K Sethi
(SK)
Smriri Rohatgi
(S)
Cherry Mammen
(C)
Anne Synnes
(A)
Sanjay Wazir
(S)
Michael Zappitelli
(M)
Robert Woroniecki
(R)
Shanty Sridhar
(S)
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