The impact of fluid balance on outcomes in critically ill near-term/term neonates: a report from the AWAKEN study group

David T Selewski; Ayse Akcan-Arikan; Elizabeth M Bonachea; Katja M Gist; Stuart L Goldstein; Mina Hanna; Catherine Joseph; John D Mahan; Arwa Nada; Amy T Nathan; Kimberly Reidy; Amy Staples; Pia Wintermark; Louis J Boohaker; Russell Griffin; David J Askenazi; Ronnie Guillet; Neonatal Kidney Collaborative

doi:10.1038/s41390-018-0183-9

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The impact of fluid balance on outcomes in critically ill near-term/term neonates: a report from the AWAKEN study group

Journal article

Open access

Peer reviewed

The impact of fluid balance on outcomes in critically ill near-term/term neonates: a report from the AWAKEN study group

David T Selewski, Ayse Akcan-Arikan, Elizabeth M Bonachea, Katja M Gist, Stuart L Goldstein, Mina Hanna, Catherine Joseph, John D Mahan, Arwa Nada, Amy T Nathan, …

Pediatric research, Vol.85(1), pp.79-85

01/2019

DOI: 10.1038/s41390-018-0183-9

PMCID: PMC6941736

PMID: 30237572

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Abstract

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.

India

North America

Acute Kidney Injury - diagnosis

Acute Kidney Injury - mortality

Acute Kidney Injury - physiopathology

Acute Kidney Injury - therapy

Adult

Birth Weight

Critical Illness

Female

Gestational Age

Hospital Mortality

Humans

Infant, Newborn

Infant, Premature

Intensive Care Units, Neonatal

Male

Premature Birth

Respiration, Artificial

Retrospective Studies

Risk Factors

Term Birth

Time Factors

Treatment Outcome

Water-Electrolyte Balance

Water-Electrolyte Imbalance - diagnosis

Water-Electrolyte Imbalance - mortality

Water-Electrolyte Imbalance - physiopathology

Water-Electrolyte Imbalance - therapy

Weight Gain

Young Adult

Details

Title: Subtitle: The impact of fluid balance on outcomes in critically ill near-term/term neonates: a report from the AWAKEN study group
Creators: David T Selewski - C. S. Mott Children's Hospital
Ayse Akcan-Arikan - Baylor College of Medicine
Elizabeth M Bonachea - Nationwide Children's Hospital
Katja M Gist - Children's Hospital Colorado
Stuart L Goldstein - Cincinnati Children's Hospital Medical Center
Mina Hanna - University of Kentucky
Catherine Joseph - Texas Children's Hospital
John D Mahan - The Ohio State University
Arwa Nada - University of Tennessee Health Science Center
Amy T Nathan - Cincinnati Children's Hospital Medical Center
Kimberly Reidy - Albert Einstein College of Medicine
Amy Staples - University of New Mexico
Pia Wintermark - McGill University
Louis J Boohaker - University of Alabama at Birmingham
Russell Griffin - University of Alabama at Birmingham
David J Askenazi - University of Alabama at Birmingham
Ronnie Guillet - Golisano Children's Hospital
Neonatal Kidney Collaborative
Contributors: Tarah T Colaizy (Contributor) - University of Iowa, Neonatology
Jonathan M Klein (Contributor) - University of Iowa, Neonatology
Resource Type: Journal article
Publication Details: Pediatric research, Vol.85(1), pp.79-85
DOI: 10.1038/s41390-018-0183-9
PMID: 30237572
PMCID: PMC6941736
ISSN: 0031-3998
eISSN: 1530-0447
Grant note: UL1 TR001417 / NCATS NIH HHS U54 TR001356 / NCATS NIH HHS R01 DK049419 / NIDDK NIH HHS UL1 TR001449 / NCATS NIH HHS R01 HL102497 / NHLBI NIH HHS UL1 TR003096 / NCATS NIH HHS
Language: English
Date published: 01/2019
Academic Unit: Stead Family Department of Pediatrics; Neonatology
Record Identifier: 9984354148502771

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