دورية أكاديمية
Positive Cumulative Fluid Balance Is Associated With Mortality in Pediatric Acute Respiratory Distress Syndrome in the Setting of Acute Kidney Injury.
| العنوان: | Positive Cumulative Fluid Balance Is Associated With Mortality in Pediatric Acute Respiratory Distress Syndrome in the Setting of Acute Kidney Injury. |
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| المؤلفون: | Zinter, Matt S, Spicer, Aaron C, Liu, Kathleen D, Orwoll, Benjamin E, Alkhouli, Mustafa F, Brakeman, Paul R, Calfee, Carolyn S, Matthay, Michael A, Sapru, Anil |
| المصدر: | Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies, vol 20, iss 4 |
| بيانات النشر: | eScholarship, University of California |
| سنة النشر: | 2019 |
| المجموعة: | University of California: eScholarship |
| مصطلحات موضوعية: | Humans, Interleukin-6, Respiration, Artificial, Severity of Illness Index, Risk Factors, Prospective Studies, Age Factors, Sex Factors, Water-Electrolyte Balance, Adolescent, Child, Preschool, Infant, Intensive Care Units, Pediatric, Female, Male, Acute Kidney Injury, Biomarkers, Respiratory Distress Syndrome, Racial Groups, Clinical Research, Acute Respiratory Distress Syndrome, Kidney Disease, Patient Safety, Lung, Physical Injury - Accidents and Adverse Effects, Rare Diseases, Renal and urogenital |
| جغرافية الموضوع: | 323 - 331 |
| الوصف: | ObjectivesAs acute kidney injury and elevated cumulative fluid balance commonly co-occur in pediatric acute respiratory distress syndrome, we aimed to identify risk factors for their development and evaluate their independent relationships with mortality. We hypothesized that acute kidney injury and elevated cumulative fluid balance would be associated with markers of inflammation and that children with elevated cumulative fluid balance and concomitant acute kidney injury would have worse outcomes than other children.DesignProspective observational study using the pediatric Risk, Injury, Failure, Loss, End-Stage acute kidney injury classification.SettingFive academic PICUs.PatientsTwo-hundred sixty patients 1 month to 18 years old meeting the Berlin definition of acute respiratory distress syndrome between 2008 and 2014.InterventionsNone.Measurements and resultsPICU mortality was 13% (34/260). Relative to survivors, nonsurvivors had greater cumulative fluid balance on day 3 of acute respiratory distress syndrome (+90.1 mL/kg; interquartile range 26.6-161.7 vs +44.9 mL/kg; interquartile range 10.0-111.3; p = 0.008) and also had higher prevalence of acute kidney injury on day 3 of acute respiratory distress syndrome (50% vs 23%; p = 0.001). On stratified analysis, greater cumulative fluid balance on day 3 of acute respiratory distress syndrome was associated with mortality among patients with concomitant acute kidney injury (+111.5 mL/kg for nonsurvivors; interquartile range 82.6-236.8 vs +58.5 mL/kg for survivors; interquartile range 0.9-176.2; p = 0.041) but not among patients without acute kidney injury (p = 0.308). The presence of acute kidney injury on acute respiratory distress syndrome day 3 was associated with mortality among patients with positive cumulative fluid balance (29.1% vs 10.4% mortality; p = 0.001) but not among patients with even or negative cumulative fluid balance (p = 0.430). Day 1 plasma interleukin-6 levels were associated with the development of day 3 positive cumulative fluid balance, ... |
| نوع الوثيقة: | article in journal/newspaper |
| وصف الملف: | application/pdf |
| اللغة: | unknown |
| العلاقة: | qt7tp3k55v; https://escholarship.org/uc/item/7tp3k55vTest; https://escholarship.org/content/qt7tp3k55v/qt7tp3k55v.pdfTest |
| DOI: | 10.1097/pcc.0000000000001845 |
| الإتاحة: | https://doi.org/10.1097/pcc.0000000000001845Test https://escholarship.org/uc/item/7tp3k55vTest https://escholarship.org/content/qt7tp3k55v/qt7tp3k55v.pdfTest |
| حقوق: | public |
| رقم الانضمام: | edsbas.8DAA46EE |
| قاعدة البيانات: | BASE |
| DOI: | 10.1097/pcc.0000000000001845 |
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