Weight-based determination of fluid overload status and mortality in pediatric intensive care unit patients requiring continuous renal replacement therapy
| العنوان: | Weight-based determination of fluid overload status and mortality in pediatric intensive care unit patients requiring continuous renal replacement therapy |
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| المؤلفون: | Yong Y. Han, Thomas P. Shanley, Rebecca M. Lombel, Neal B. Blatt, Mallika Kommareddi, Michael Heung, Theresa Mottes, David B. Kershaw, Timothy T. Cornell, David T. Selewski |
| المصدر: | Intensive Care Medicine. 37:1166-1173 |
| بيانات النشر: | Springer Science and Business Media LLC, 2011. |
| سنة النشر: | 2011 |
| مصطلحات موضوعية: | Male, medicine.medical_specialty, Resuscitation, Adolescent, medicine.medical_treatment, Intensive Care Units, Pediatric, Critical Care and Intensive Care Medicine, Statistics, Nonparametric, Article, law.invention, Risk Factors, law, Intensive care, Anesthesiology, medicine, Humans, Renal replacement therapy, Child, Intensive care medicine, Retrospective Studies, Pediatric intensive care unit, business.industry, Body Weight, Acute kidney injury, Infant, Acute Kidney Injury, Water-Electrolyte Balance, medicine.disease, Intensive care unit, Renal Replacement Therapy, Survival Rate, ROC Curve, Area Under Curve, Child, Preschool, Female, business, Kidney disease |
| الوصف: | In pediatric intensive care unit (PICU) patients, fluid overload (FO) at initiation of continuous renal replacement therapy (CRRT) has been reported to be an independent risk factor for mortality. Previous studies have calculated FO based on daily fluid balance during ICU admission, which is labor intensive and error prone. We hypothesized that a weight-based definition of FO at CRRT initiation would correlate with the fluid balance method and prove predictive of outcome.This is a retrospective single-center review of PICU patients requiring CRRT from July 2006 through February 2010 (n = 113). We compared the degree of FO at CRRT initiation using the standard fluid balance method versus methods based on patient weight changes assessed by both univariate and multivariate analyses.The degree of fluid overload at CRRT initiation was significantly greater in nonsurvivors, irrespective of which method was used. The univariate odds ratio for PICU mortality per 1% increase in FO was 1.056 [95% confidence interval (CI) 1.025, 1.087] by the fluid balance method, 1.044 (95% CI 1.019, 1.069) by the weight-based method using PICU admission weight, and 1.045 (95% CI 1.022, 1.07) by the weight-based method using hospital admission weight. On multivariate analyses, all three methods approached significance in predicting PICU survival.Our findings suggest that weight-based definitions of FO are useful in defining FO at CRRT initiation and are associated with increased mortality in a broad PICU patient population. This study provides evidence for a more practical weight-based definition of FO that can be used at the bedside. |
| تدمد: | 1432-1238 0342-4642 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::ef3a84c4ce3243bd8cfda65939834d6e https://doi.org/10.1007/s00134-011-2231-3 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....ef3a84c4ce3243bd8cfda65939834d6e |
| قاعدة البيانات: | OpenAIRE |
Find this article in full text from Springer Verlag. | تدمد: | 14321238 03424642 |
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