1. Positive fluid balance and diuretic therapy are associated with mechanical ventilation and mortality in preterm neonates in the first fourteen postnatal days
- Author
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Wright, Mariah L., Klamer, Brett G., Bonachea, Elizabeth, Spencer, John D., Slaughter, Jonathan L., and Mohamed, Tahagod H.
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Water-electrolyte balance (Physiology) -- Health aspects ,Artificial respiration -- Forecasts and trends -- Demographic aspects ,Osmoregulation -- Health aspects ,Infants (Premature) -- Care and treatment ,Diuretics -- Dosage and administration ,Market trend/market analysis ,Health - Abstract
Background Fluid overload leads to poor neonatal outcomes. Diuretics may lower the rates of mechanical ventilation (MV) and mortality in neonates with fluid overload. Methods This is a retrospective study of preterm neonates [less than or equal to] 36 weeks of gestational age (GA) in the first 14 postnatal days in a level IV NICU in 2014-2020. We evaluated the epidemiology of fluid balance in the first 14 postnatal days and its association with MV and mortality and studied the association of diuretics with fluid balance, MV, and mortality. Results In 1383 included neonates, the overall median lowest and peak fluid balances were - 7.8% (IQR: - 11.7, - 4.6) and 8% (3, 16) on days 3 (2, 5) and 13 (5, 14), respectively. Fluid balance distribution varied significantly by GA. Peak fluid balance of [greater than or equal to] 10% was associated with increased odds of MV on days 7 and 14 with highest odds ratios (OR) of MV in neonates with fluid balance [greater than or equal to] 15%. Peak fluid balance of [greater than or equal to] 15% was associated with the greatest odds of mortality. Diuretics were used more frequently in neonates with younger GA, smaller birthweight, positive fluid balance, and those on MV. Conclusions Positive fluid balance negatively impacts pulmonary status. The odds of MV and death increase significantly as peak fluid balance percentage increases in all GA groups. The impact of diuretics on MV and death in preterm neonates needs further evaluation. Graphical abstract, Author(s): Mariah L. Wright [sup.1] , Brett G. Klamer [sup.2] [sup.3] [sup.4] , Elizabeth Bonachea [sup.1] , John D. Spencer [sup.1] [sup.2] [sup.3] , Jonathan L. Slaughter [sup.1] [sup.5] [sup.6] [...]
- Published
- 2023
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