Katherine M Ottolini1,2,3, Sudeepta K Basu1,4, Nicole Herrera5, Vedavalli Govindan6, Suleiman Mashat1, Gilbert Vezina4,7, Michelande Ridore1, James Bost4,5, Taeun Chang4,8, An N Massaro9,10. 1. Division of Neonatology, Children's National Hospital, Washington, DC, USA. 2. Department of Neonatology, 18th Healthcare Operations Squadron, Kadena AB, Okinawa, Japan. 3. Department of Pediatrics, Division of Neonatology, Uniformed Services University, Bethesda, MD, USA. 4. Department of Pediatrics, The George Washington University School of Medicine, Washington, DC, USA. 5. Division of Biostatistics and Study Methodology, Children's National Hospital, Washington, DC, USA. 6. Division of Fetal and Transitional Medicine, Children's National Hospital, Washington, DC, USA. 7. Division of Diagnostic Imaging and Radiology, Children's National Hospital, Washington, DC, USA. 8. Division of Epilepsy, Neurophysiology & Critical Care, Children's National Hospital, Washington, DC, USA. 9. Division of Neonatology, Children's National Hospital, Washington, DC, USA. ANguyenM@childrensnational.org. 10. Department of Pediatrics, The George Washington University School of Medicine, Washington, DC, USA. ANguyenM@childrensnational.org.
Abstract
OBJECTIVE: To investigate the association between fluid balance during therapeutic hypothermia (TH) and severity of brain injury on magnetic resonance imaging (MRI) in neonates with hypoxic-ischemic encephalopathy (HIE). STUDY DESIGN: This is a secondary analysis of data from a prospective observational study in neonates with HIE. Daily net positive fluid balance during TH was investigated for association with the adverse primary outcome of death or moderate-to-severe brain injury on MRI using multivariable logistic regression. RESULTS: Of the 150 neonates included, 50 suffered adverse outcome and had significantly higher net positive fluid balance (53 vs. 19 ml/kg/day, p < 0.01) during first 24 hours of TH. Neonates with a net positive fluid balance (>25 ml/kg/day) at 24 hours of TH had 3.4 (95% CI 1.3-9) times higher odds of adverse outcome. CONCLUSIONS: Positive fluid balance during TH in neonates with HIE is independently associated with death or moderate-to-severe brain injury on MRI.
OBJECTIVE: To investigate the association between fluid balance during therapeutic hypothermia (TH) and severity of brain injury on magnetic resonance imaging (MRI) in neonates with hypoxic-ischemic encephalopathy (HIE). STUDY DESIGN: This is a secondary analysis of data from a prospective observational study in neonates with HIE. Daily net positive fluid balance during TH was investigated for association with the adverse primary outcome of death or moderate-to-severe brain injury on MRI using multivariable logistic regression. RESULTS: Of the 150 neonates included, 50 suffered adverse outcome and had significantly higher net positive fluid balance (53 vs. 19 ml/kg/day, p < 0.01) during first 24 hours of TH. Neonates with a net positive fluid balance (>25 ml/kg/day) at 24 hours of TH had 3.4 (95% CI 1.3-9) times higher odds of adverse outcome. CONCLUSIONS: Positive fluid balance during TH in neonates with HIE is independently associated with death or moderate-to-severe brain injury on MRI.
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