TY - JOUR
T1 - The impact of fluid balance on outcomes in premature neonates
T2 - a report from the AWAKEN study group
AU - Selewski, David T.
AU - Gist, Katja M.
AU - Nathan, Amy T.
AU - Goldstein, Stuart L.
AU - Boohaker, Louis J.
AU - Akcan-Arikan, Ayse
AU - Bonachea, Elizabeth M.
AU - Hanna, Mina
AU - Joseph, Catherine
AU - Mahan, John D.
AU - Mammen, Cherry
AU - Nada, Arwa
AU - Reidy, Kimberly
AU - Staples, Amy
AU - Wintermark, Pia
AU - Griffin, Russell
AU - Askenazi, David J.
AU - Guillet, Ronnie
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 - Soranno, Danielle E.
AU - Gien, Jason
N1 - Publisher Copyright:
© 2019, International Pediatric Research Foundation, Inc.
PY - 2020/2/1
Y1 - 2020/2/1
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=85074366989&partnerID=8YFLogxK
U2 - 10.1038/s41390-019-0579-1
DO - 10.1038/s41390-019-0579-1
M3 - Article
SN - 0031-3998
VL - 87
SP - 550
EP - 557
JO - Pediatric Research
JF - Pediatric Research
IS - 3
ER -