David T Selewski1, Ayse Akcan-Arikan2, Elizabeth M Bonachea3, Katja M Gist4, Stuart L Goldstein5, Mina Hanna6, Catherine Joseph7, John D Mahan8, Arwa Nada9, Amy T Nathan10, Kimberly Reidy11, Amy Staples12, Pia Wintermark13, Louis J Boohaker14, Russell Griffin14, David J Askenazi14, Ronnie Guillet15. 1. Division of Nephrology, Department of Pediatrics & Communicable Diseases, C.S. Mott Children's Hospital, University of Michigan, Ann Arbor, MI, USA. dselewsk@med.umich.edu. 2. Sections of Pediatric Critical Care Medicine and Renal, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA. 3. Department of Pediatrics, Section of Neonatology,Nationwide Children's Hospital, The Ohio State University, Columbus, OH, USA. 4. Department of Pediatrics, Children's Hospital Colorado, University of Colorado Anschutz Medical Campus, Aurora, CO, USA. 5. Department of Pediatrics, Center for Acute Care Nephrology, Cincinnati Children's Hospital and Medical Center, University of Cincinnati, Cincinnati, OH, USA. 6. Department Pediatrics, University of Kentucky, Lexington, KY, USA. 7. Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA. 8. Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, OH, USA. 9. Department of Pediatrics, Division of Nephrology, LeBonheur Children's Hospital, University of Tennessee Health Science Center, Memphis, TN, USA. 10. Department of Pediatrics, Perinatal Institute, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, OH, USA. 11. Division of Nephrology, Department of Pediatrics, Children's Hospital at Montefiore/ Albert Einstein College of Medicine, Bronx, NY, USA. 12. Department of Pediatrics, University of New Mexico, Albuquerque, NM, USA. 13. Department of Pediatrics, McGill University, Montreal, QC, Canada. 14. Department of Pediatrics, Pediatric and Infant Center for Acute Nephrology (PICAN), University of Alabama Birmingham, Birmingham, AL, USA. 15. Department of Pediatrics, Division of Neonatology, Golisano Children's Hospital, University of Rochester, Rochester, NY, USA.
Abstract
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.
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.
Authors: Michael Zappitelli; Namasivayam Ambalavanan; David J Askenazi; Marva M Moxey-Mims; Paul L Kimmel; Robert A Star; Carolyn L Abitbol; Patrick D Brophy; Guillermo Hidalgo; Mina Hanna; Catherine M Morgan; Tonse N K Raju; Patricio Ray; Zayhara Reyes-Bou; Amani Roushdi; Stuart L Goldstein Journal: Pediatr Res Date: 2017-07-11 Impact factor: 3.756
Authors: Ayse A Arikan; Michael Zappitelli; Stuart L Goldstein; Amrita Naipaul; Larry S Jefferson; Laura L Loftis Journal: Pediatr Crit Care Med Date: 2012-05 Impact factor: 3.624
Authors: Stuart L Goldstein; Michael J G Somers; Michelle A Baum; Jordan M Symons; Patrick D Brophy; Douglas Blowey; Timothy E Bunchman; Cheryl Baker; Theresa Mottes; Nancy McAfee; Joni Barnett; Gloria Morrison; Kristine Rogers; James D Fortenberry Journal: Kidney Int Date: 2005-02 Impact factor: 10.612
Authors: Jason A Foland; James D Fortenberry; Barry L Warshaw; Robert Pettignano; Robert K Merritt; Micheal L Heard; Kris Rogers; Chris Reid; April J Tanner; Kirk A Easley Journal: Crit Care Med Date: 2004-08 Impact factor: 7.598
Authors: Alexandra J M Zwiers; Saskia N de Wildt; Wim C J Hop; Eiske M Dorresteijn; Saskia J Gischler; Dick Tibboel; Karlien Cransberg Journal: Crit Care Date: 2013-07-24 Impact factor: 9.097
Authors: Matthew W Harer; David T Selewski; Kianoush Kashani; Rajit K Basu; Katja M Gist; Jennifer G Jetton; Scott M Sutherland; Michael Zappitelli; Stuart L Goldstein; Theresa Ann Mottes; David J Askenazi Journal: J Perinatol Date: 2020-09-05 Impact factor: 2.521
Authors: Tara M Neumayr; Jeffrey A Alten; David K Bailly; Priya N Bhat; Katie L Brandewie; J Wesley Diddle; Muhammad Ghbeis; Catherine D Krawczeski; Kenneth E Mah; Tia T Raymond; Garrett Reichle; Huaiyu Zang; David T Selewski Journal: Pediatr Nephrol Date: 2022-09-06 Impact factor: 3.651
Authors: Arwa Nada; David Askenazi; Juan C Kupferman; Maroun Mhanna; John D Mahan; Louis Boohaker; Linzi Li; Russell L Griffin Journal: Pediatr Nephrol Date: 2021-10-18 Impact factor: 3.651
Authors: Abby M Basalely; Russell Griffin; Katja M Gist; Ronnie Guillet; David J Askenazi; Jennifer R Charlton; David T Selewski; Mamta Fuloria; Frederick J Kaskel; Kimberly J Reidy Journal: J Perinatol Date: 2021-11-13 Impact factor: 3.225
Authors: Mignon McCulloch; Valerie A Luyckx; Brett Cullis; Simon J Davies; Fredric O Finkelstein; Hui Kim Yap; John Feehally; William E Smoyer Journal: Nat Rev Nephrol Date: 2020-10-01 Impact factor: 28.314