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

on behalf of the Neonatal Kidney Collaborative

doi:10.1038/s41390-018-0183-9

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

on behalf of the Neonatal Kidney Collaborative

Pediatrics

University of Michigan, Ann Arbor
Baylor College of Medicine
Ohio State University
University of Colorado Anschutz Medical Campus
University of Cincinnati
University of Kentucky
University of Tennessee Health Science Center
Albert Einstein College of Medicine
University of New Mexico
McGill University
University of Alabama at Birmingham
University of Rochester
Seattle Children’s Hospital
University of Miami
University of Virginia
Case Western Reserve University
Maimonides Medical Center
University of Hawai'i at Mānoa
Washington University St. Louis
Tufts University

Research output: Contribution to journal › Article › peer-review

62 Scopus citations

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.

Original language	English
Pages (from-to)	79-85
Number of pages	7
Journal	Pediatric Research
Volume	85
Issue number	1
DOIs	https://doi.org/10.1038/s41390-018-0183-9
State	Published - Jan 1 2019

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@article{ce15f5034d6e4611a238ae1db3ef2682,

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

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.",

author = "\{on behalf of the Neonatal Kidney Collaborative\} and Selewski, \{David T.\} and Ayse Akcan-Arikan and Bonachea, \{Elizabeth M.\} and Gist, \{Katja M.\} and Goldstein, \{Stuart L.\} and Mina Hanna and Catherine Joseph and Mahan, \{John D.\} and Arwa Nada and Nathan, \{Amy T.\} and Kimberly Reidy and Amy Staples and Pia Wintermark and Boohaker, \{Louis J.\} and Russell Griffin and Askenazi, \{David J.\} and Ronnie Guillet and Sunny Juul and Namasivayam Ambalavanan and Subrata Sarkar and Alison Kent and Jeffery Fletcher and Abitbol, \{Carolyn L.\} and Marissa DeFreitas and Shahnaz Duara and Charlton, \{Jennifer R.\} and Swanson, \{Jonathan R.\} and Carl D{\textquoteright}Angio and Ayesa Mian and Erin Rademacher and Mhanna, \{Maroun J.\} and Rupesh Raina and Deepak Kumar and Jetton, \{Jennifer G.\} and Brophy, \{Patrick D.\} and Colaizy, \{Tarah T.\} and Klein, \{Jonathan M.\} and Rhee, \{Christopher J.\} and Kupferman, \{Juan C.\} and Alok Bhutada and Shantanu Rastogi and Susan Ingraham and Cole, \{F. Sessions\} and Davis, \{T. Keefe\} and Lawrence Milner and Alexandra Smith and Mamta Fuloria and Kaskel, \{Frederick J.\} and Robert Woroniecki and Shanty Sridhar",

note = "Publisher Copyright: {\textcopyright} 2018, International Pediatric Research Foundation, Inc.",

year = "2019",

month = jan,

day = "1",

doi = "10.1038/s41390-018-0183-9",

language = "English",

volume = "85",

pages = "79--85",

journal = "Pediatric Research",

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TY - JOUR

T1 - The impact of fluid balance on outcomes in critically ill near-term/term neonates

T2 - a report from the AWAKEN study group

AU - on behalf of the Neonatal Kidney Collaborative

AU - Selewski, David T.

AU - Akcan-Arikan, Ayse

AU - Bonachea, Elizabeth M.

AU - Gist, Katja M.

AU - Goldstein, Stuart L.

AU - Hanna, Mina

AU - Joseph, Catherine

AU - Mahan, John D.

AU - Nada, Arwa

AU - Nathan, Amy T.

AU - Reidy, Kimberly

AU - Staples, Amy

AU - Wintermark, Pia

AU - Boohaker, Louis J.

AU - Griffin, Russell

AU - Askenazi, David J.

AU - Guillet, Ronnie

AU - Juul, Sunny

AU - Ambalavanan, Namasivayam

AU - Sarkar, Subrata

AU - Kent, Alison

AU - Fletcher, Jeffery

AU - Abitbol, Carolyn L.

AU - DeFreitas, Marissa

AU - Duara, Shahnaz

AU - Charlton, Jennifer R.

AU - Swanson, Jonathan R.

AU - D’Angio, Carl

AU - Mian, Ayesa

AU - Rademacher, Erin

AU - Mhanna, Maroun J.

AU - Raina, Rupesh

AU - Kumar, Deepak

AU - Jetton, Jennifer G.

AU - Brophy, Patrick D.

AU - Colaizy, Tarah T.

AU - Klein, Jonathan M.

AU - Rhee, Christopher J.

AU - Kupferman, Juan C.

AU - Bhutada, Alok

AU - Rastogi, Shantanu

AU - Ingraham, Susan

AU - Cole, F. Sessions

AU - Davis, T. Keefe

AU - Milner, Lawrence

AU - Smith, Alexandra

AU - Fuloria, Mamta

AU - Kaskel, Frederick J.

AU - Woroniecki, Robert

AU - Sridhar, Shanty

PY - 2019/1/1

Y1 - 2019/1/1

N2 - 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.

AB - 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.

UR - https://www.scopus.com/pages/publications/85056730559

U2 - 10.1038/s41390-018-0183-9

DO - 10.1038/s41390-018-0183-9

M3 - Article

C2 - 30237572

AN - SCOPUS:85056730559

SN - 0031-3998

VL - 85

SP - 79

EP - 85

JO - Pediatric Research

JF - Pediatric Research

IS - 1

ER -

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

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