Positive fluid balance is associated with death and severity of brain injury in neonates with hypoxic-ischemic encephalopathy.

Katherine M Ottolini, Sudeepta K Basu, Nicole Herrera, Vedavalli Govindan, Suleiman Mashat, Gilbert Vezina, Michelande Ridore, James Bost, Taeun Chang, An N Massaro

Journal: Journal of perinatology : official journal of the California Perinatal Association 2021;41(6):1331-1338

PMID: 33649446

Free Full Text on PubMed Central View on PubMed

Abstract

OBJECTIVE

To investigate the association between fluid balance during therapeutic hypothermia (TH) and severity of brain injury on magnetic resonance imaging (MRI) in neonates with hypoxic-ischemic encephalopathy (HIE).

STUDY DESIGN

This is a secondary analysis of data from a prospective observational study in neonates with HIE. Daily net positive fluid balance during TH was investigated for association with the adverse primary outcome of death or moderate-to-severe brain injury on MRI using multivariable logistic regression.

RESULTS

Of the 150 neonates included, 50 suffered adverse outcome and had significantly higher net positive fluid balance (53 vs. 19 ml/kg/day, p < 0.01) during first 24 hours of TH. Neonates with a net positive fluid balance (>25 ml/kg/day) at 24 hours of TH had 3.4 (95% CI 1.3-9) times higher odds of adverse outcome.

CONCLUSIONS

Positive fluid balance during TH in neonates with HIE is independently associated with death or moderate-to-severe brain injury on MRI.

Address: Division of Neonatology, Children's National Hospital, Washington, DC, USA.; Department of Neonatology, 18th Healthcare Operations Squadron, Kadena AB, Okinawa, Japan.; Department of Pediatrics, Division of Neonatology, Uniformed Services University, Bethesda, MD, USA.; Department of Pediatrics, The George Washington University School of Medicine, Washington, DC, USA.; Division of Biostatistics and Study Methodology, Children's National Hospital, Washington, DC, USA.; Division of Fetal and Transitional Medicine, Children's National Hospital, Washington, DC, USA.; Division of Diagnostic Imaging and Radiology, Children's National Hospital, Washington, DC, USA.; Division of Epilepsy, Neurophysiology & Critical Care, Children's National Hospital, Washington, DC, USA.; Division of Neonatology, Children's National Hospital, Washington, DC, USA. [email protected].; Department of Pediatrics, The George Washington University School of Medicine, Washington, DC, USA. [email protected].

DOI: 10.1038/s41372-021-00988-w

Link outs

Free resources

Full Text Sources:

Other Literature Sources:

https://scite.ai/reports/33649446

Subscription / membership required

Full Text Sources:

https://doi.org/10.1038/s41372-021-00988-w

MeSH Terms: Brain Injuries, Humans, Hypoxia-Ischemia, Brain, Infant, Newborn, Water-Electrolyte Balance