Assessment of fluid balance after neonatal cardiac surgery: Intake/output vs. weight-based methods
Presented By:
Tara M. Neumayr, Jeffrey A. Alten, David K. Bailly, Priya N. Bhat, Katie L. Brandewie, J. Wesley Diddle, Muhammad Ghbeis, Catherine D. Krawczeski, Kenneth E. Mah, Tia T. Raymond, Garrett Reichle, Huaiyu Zang, David T. Selewski
Washington University School of Medicine, Divisions of Pediatric Critical Care Medicine and Pediatric Nephrology, St. Louis, MO
neumayr_t@wustl.edu
neumayr_t@wustl.edu
Overview:
Introduction: Fluid overload associates with poor outcomes after neonatal cardiac surgery. Consensus does not exist for the most clinically relevant method of measuring fluid balance (FB). While weight-change based FB (FB-W) is standard in neonatal intensive care units, weighing infants after cardiac surgery may be challenging.
Study Aims: Identify characteristics associated with obtaining weights after neonatal cardiac surgery. Describe how intake/output-based FB (FB-IO) and FB-W compare in the early postoperative period in this population.
Methods: Observational retrospective study of 2235 neonates undergoing cardiac surgery from 22 hospitals comprising the Neonatal and Pediatric Heart and Renal Outcomes Network (NEPHRON) database.
Conclusions: Weighing neonates early after cardiac surgery is uncommon. There is significant practice variation among centers in our cohort. Patients with increased severity/complexity of illness are less likely to be weighed. FB-W and FB-IO have weak correlation. Further study is needed to determine which cumulative FB metric most associates with adverse outcomes in order to guide development of best practices and to identify interventions to influence outcomes.
Study Aims: Identify characteristics associated with obtaining weights after neonatal cardiac surgery. Describe how intake/output-based FB (FB-IO) and FB-W compare in the early postoperative period in this population.
Methods: Observational retrospective study of 2235 neonates undergoing cardiac surgery from 22 hospitals comprising the Neonatal and Pediatric Heart and Renal Outcomes Network (NEPHRON) database.
Conclusions: Weighing neonates early after cardiac surgery is uncommon. There is significant practice variation among centers in our cohort. Patients with increased severity/complexity of illness are less likely to be weighed. FB-W and FB-IO have weak correlation. Further study is needed to determine which cumulative FB metric most associates with adverse outcomes in order to guide development of best practices and to identify interventions to influence outcomes.
