Pattern of Fluid Overload and its Impact on Mortality Among Mechanically Ventilated Children : Secondary Analysis of the ReLiSCh Trial
© 2024. The Author(s), under exclusive licence to Dr. K C Chaudhuri Foundation..
OBJECTIVES: To assess the pattern of fluid overload (FO) and its impact on mortality among mechanically ventilated children.
METHODS: In this secondary analysis of an open-label randomized controlled trial (ReLiSCh trial, October 2020-September 2021), hemodynamically stable mechanically ventilated children (n = 100) admitted to a tertiary level pediatric intensive care unit (PICU) in North India were enrolled. The primary outcome was pattern of FO (FO% >10% and cumulative FO% from day 1-7); and secondary outcomes were pattern of FO among survivors and non-survivors, and prescription practices of maintenance fluid.
RESULTS: The median (IQR) age was 3.5 (0.85-7.5) y and 57% were males. Common diagnoses were pneumonia (27%), scrub typhus (14%), Landry-Guillain-Barré syndrome (9%), dengue (8%), central nervous system infections (7%) and staphylococcal sepsis (6%). Common organ dysfunction included acute respiratory distress syndrome (ARDS) (41%), shock (38%), and acute kidney injury (AKI) (9%). The duration PICU stay was 11 (7-17) d and mortality was 12%. The FO% >10% was noted in 19% children; and there was significant increase in cumulative FO% from day 1-7 [1.2 (0.2-2.6)% to 8.5 (1.7-14.3)%, (p = 0.000)]. Among non-survivors, higher proportion had FO% >10% (66.7% vs. 12.5%, p 0.0001); and trend towards higher cumulative FO% on first seven days. From day 1-7, the percentage of maintenance fluid received increased from 60 (50-71)% to 70 (60-77)% (p = 0.691).
CONCLUSIONS: One-fifth of mechanically ventilated children had FO% >10% and there was significant increase in cumulative FO% from day 1-7. Non-survivors had significantly higher degree of FO.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2024 |
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| Enthalten in: |
Indian journal of pediatrics - (2024) vom: 26. Feb. |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Charaya, Shubham [VerfasserIn] |
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| Links: |
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| Themen: |
Critically ill children |
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| Anmerkungen: |
Date Revised 25.02.2024 published: Print-Electronic Citation Status Publisher |
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| doi: |
10.1007/s12098-024-05059-4 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM368937852 |
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| 100 | 1 | |a Charaya, Shubham |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Pattern of Fluid Overload and its Impact on Mortality Among Mechanically Ventilated Children |b Secondary Analysis of the ReLiSCh Trial |
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| 500 | |a Date Revised 25.02.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status Publisher | ||
| 520 | |a © 2024. The Author(s), under exclusive licence to Dr. K C Chaudhuri Foundation. | ||
| 520 | |a OBJECTIVES: To assess the pattern of fluid overload (FO) and its impact on mortality among mechanically ventilated children | ||
| 520 | |a METHODS: In this secondary analysis of an open-label randomized controlled trial (ReLiSCh trial, October 2020-September 2021), hemodynamically stable mechanically ventilated children (n = 100) admitted to a tertiary level pediatric intensive care unit (PICU) in North India were enrolled. The primary outcome was pattern of FO (FO% >10% and cumulative FO% from day 1-7); and secondary outcomes were pattern of FO among survivors and non-survivors, and prescription practices of maintenance fluid | ||
| 520 | |a RESULTS: The median (IQR) age was 3.5 (0.85-7.5) y and 57% were males. Common diagnoses were pneumonia (27%), scrub typhus (14%), Landry-Guillain-Barré syndrome (9%), dengue (8%), central nervous system infections (7%) and staphylococcal sepsis (6%). Common organ dysfunction included acute respiratory distress syndrome (ARDS) (41%), shock (38%), and acute kidney injury (AKI) (9%). The duration PICU stay was 11 (7-17) d and mortality was 12%. The FO% >10% was noted in 19% children; and there was significant increase in cumulative FO% from day 1-7 [1.2 (0.2-2.6)% to 8.5 (1.7-14.3)%, (p = 0.000)]. Among non-survivors, higher proportion had FO% >10% (66.7% vs. 12.5%, p 0.0001); and trend towards higher cumulative FO% on first seven days. From day 1-7, the percentage of maintenance fluid received increased from 60 (50-71)% to 70 (60-77)% (p = 0.691) | ||
| 520 | |a CONCLUSIONS: One-fifth of mechanically ventilated children had FO% >10% and there was significant increase in cumulative FO% from day 1-7. Non-survivors had significantly higher degree of FO | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Critically ill children | |
| 650 | 4 | |a Fluid creep | |
| 650 | 4 | |a Fluid overload | |
| 650 | 4 | |a Maintenance fluids | |
| 650 | 4 | |a Mechanical ventilation | |
| 700 | 1 | |a Angurana, Suresh Kumar |e verfasserin |4 aut | |
| 700 | 1 | |a Nallasamy, Karthi |e verfasserin |4 aut | |
| 700 | 1 | |a Bansal, Arun |e verfasserin |4 aut | |
| 700 | 1 | |a Muralidharan, Jayashree |e verfasserin |4 aut | |
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