Positive Fluid Balance Is Associated with Higher Mortality and Prolonged Mechanical Ventilation in Pediatric Patients with Acute Lung Injury
Introduction. We analyzed a database of 320 pediatric patients with acute lung injury (ALI), to test the hypothesis that positive fluid balance is associated with worse clinical outcomes in children with ALI. Methods. This is a post-hoc analysis of previously collected data. Cumulative fluid balance...
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| Format: | Article |
| Language: | English |
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Wiley
2011-01-01
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| Series: | Critical Care Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2011/854142 |
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| author | Heidi R. Flori Gwynne Church Kathleen D. Liu Ginny Gildengorin Michael A. Matthay |
| author_facet | Heidi R. Flori Gwynne Church Kathleen D. Liu Ginny Gildengorin Michael A. Matthay |
| author_sort | Heidi R. Flori |
| collection | DOAJ |
| description | Introduction. We analyzed a database of 320 pediatric patients with acute lung injury (ALI), to test the hypothesis that positive fluid balance is associated with worse clinical outcomes in children with ALI. Methods. This is a post-hoc analysis of previously collected data. Cumulative fluid balance was analyzed in ml per kilogram per day for the first 72 hours after ALI while in the PICU. The primary outcome was mortality; the secondary outcome was ventilator-free days. Results. Positive fluid balance (in increments of 10 mL/kg/24 h) was associated with a significant increase in both mortality and prolonged duration of mechanical ventilation, independent of the presence of multiple organ system failure and the extent of oxygenation defect. These relationships remained unchanged when the subgroup of patients with septic shock (n=39) were excluded. Conclusions. Persistently positive fluid balance may be deleterious to pediatric patients with ALI. A confirmatory, prospective randomized controlled trial of fluid management in pediatric patients with ALI is warranted. |
| format | Article |
| id | doaj-art-36f984af927c4664bcaeb9acf397cfc4 |
| institution | Kabale University |
| issn | 2090-1305 2090-1313 |
| language | English |
| publishDate | 2011-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Critical Care Research and Practice |
| spelling | doaj-art-36f984af927c4664bcaeb9acf397cfc42025-02-03T01:06:55ZengWileyCritical Care Research and Practice2090-13052090-13132011-01-01201110.1155/2011/854142854142Positive Fluid Balance Is Associated with Higher Mortality and Prolonged Mechanical Ventilation in Pediatric Patients with Acute Lung InjuryHeidi R. Flori0Gwynne Church1Kathleen D. Liu2Ginny Gildengorin3Michael A. Matthay4Division of Pediatric Critical Care, Children’s Hospital and Research Center Oakland, 747 52nd Street, Oakland, CA 94609, USADivision of Pediatric Pulmonology, UCSF Children’s Hospital, San Francisco, CA 94143, USADivision of Nephrology, UCSF Medical Center, San Francisco, CA 94143, USADepartment of Epidemiology and Biostatistics, CTSI, Children’s Hospital and Research Center Oakland, 747 52nd Street, Oakland, CA 94609, USADepartment of Anesthesia and Critical Care and CVRI, UCSF Medical Center, San Francisco, CA 94143, USAIntroduction. We analyzed a database of 320 pediatric patients with acute lung injury (ALI), to test the hypothesis that positive fluid balance is associated with worse clinical outcomes in children with ALI. Methods. This is a post-hoc analysis of previously collected data. Cumulative fluid balance was analyzed in ml per kilogram per day for the first 72 hours after ALI while in the PICU. The primary outcome was mortality; the secondary outcome was ventilator-free days. Results. Positive fluid balance (in increments of 10 mL/kg/24 h) was associated with a significant increase in both mortality and prolonged duration of mechanical ventilation, independent of the presence of multiple organ system failure and the extent of oxygenation defect. These relationships remained unchanged when the subgroup of patients with septic shock (n=39) were excluded. Conclusions. Persistently positive fluid balance may be deleterious to pediatric patients with ALI. A confirmatory, prospective randomized controlled trial of fluid management in pediatric patients with ALI is warranted.http://dx.doi.org/10.1155/2011/854142 |
| spellingShingle | Heidi R. Flori Gwynne Church Kathleen D. Liu Ginny Gildengorin Michael A. Matthay Positive Fluid Balance Is Associated with Higher Mortality and Prolonged Mechanical Ventilation in Pediatric Patients with Acute Lung Injury Critical Care Research and Practice |
| title | Positive Fluid Balance Is Associated with Higher Mortality and Prolonged Mechanical Ventilation in Pediatric Patients with Acute Lung Injury |
| title_full | Positive Fluid Balance Is Associated with Higher Mortality and Prolonged Mechanical Ventilation in Pediatric Patients with Acute Lung Injury |
| title_fullStr | Positive Fluid Balance Is Associated with Higher Mortality and Prolonged Mechanical Ventilation in Pediatric Patients with Acute Lung Injury |
| title_full_unstemmed | Positive Fluid Balance Is Associated with Higher Mortality and Prolonged Mechanical Ventilation in Pediatric Patients with Acute Lung Injury |
| title_short | Positive Fluid Balance Is Associated with Higher Mortality and Prolonged Mechanical Ventilation in Pediatric Patients with Acute Lung Injury |
| title_sort | positive fluid balance is associated with higher mortality and prolonged mechanical ventilation in pediatric patients with acute lung injury |
| url | http://dx.doi.org/10.1155/2011/854142 |
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