Medical College of Wisconsin
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The impact of fluid balance on outcomes in premature neonates: a report from the AWAKEN study group. Pediatr Res 2020 Feb;87(3):550-557

Date

09/20/2019

Pubmed ID

31537009

Pubmed Central ID

PMC7036003

DOI

10.1038/s41390-019-0579-1

Scopus ID

2-s2.0-85074366989 (requires institutional sign-in at Scopus site)   64 Citations

Abstract

BACKGROUND: We evaluated the epidemiology of fluid balance (FB) over the first postnatal week and its impact on outcomes in a multi-center cohort of premature neonates from the AWAKEN study.

METHODS: Retrospective analysis of infants <36 weeks' gestational age from the AWAKEN study (N = 1007). FB was defined by percentage of change from birth weight.

OUTCOME: Mechanical ventilation (MV) at postnatal day 7.

RESULTS: One hundred and forty-nine (14.8%) were on MV at postnatal day 7. The median peak FB was 0% (IQR: -2.9, 2) and occurred on postnatal day 2 (IQR: 1,5). Multivariable models showed that the peak FB (aOR 1.14, 95% CI 1.10-1.19), lowest FB in first postnatal week (aOR 1.12, 95% CI 1.07-1.16), and FB on postnatal day 7 (aOR 1.10, 95% CI 1.06-1.13) were independently associated with MV on postnatal day 7. In a similar analysis, a negative FB at postnatal day 7 protected against the need for MV at postnatal day 7 (aOR 0.21, 95% CI 0.12-0.35).

CONCLUSIONS: Positive peak FB during the first postnatal week and more positive FB on postnatal day 7 were independently associated with MV at postnatal day 7. Those with a negative FB at postnatal day 7 were less likely to require MV.

Author List

Selewski DT, Gist KM, Nathan AT, Goldstein SL, Boohaker LJ, Akcan-Arikan A, Bonachea EM, Hanna M, Joseph C, Mahan JD, Mammen C, Nada A, Reidy K, Staples A, Wintermark P, Griffin R, Askenazi DJ, Guillet R, Neonatal Kidney Collaborative

Author

Jennifer G. Jetton MD Chief, Professor in the Pediatrics department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Acute Kidney Injury
Birth Weight
Canada
Female
Fluid Shifts
Gestational Age
Humans
Infant, Newborn
Infant, Premature
Male
Prognosis
Respiration, Artificial
Retrospective Studies
Risk Assessment
Risk Factors
Time Factors
United States
Water-Electrolyte Balance
Water-Electrolyte Imbalance