Cumulative fluid intake minus output is not associated with ventilator weaning duration or extubation outcomes in children*

Abstract

Although routinely recorded, cumulative fluid I-O does not appear to have clinical utility in cases managed according to a mechanical ventilator protocol in which tidal volume and oxygenation on minimal levels of ventilator support are systematically tested.

Pediatric Acute Respiratory Distress Syndrome

“…67 Although definitive fluid-management data do not currently exist for pediatric ALI/ARDS patients, a general approach to the infant or child with ALI is to similarly use diuretics with a conservative fluid-management strategy in mind. The PALISI Network 5,6,18 is currently considering such a study. Key issues for a clinical fluid-management investigation include the optimal fluid targets (eg, in/out fluid balance, central venous pressure, and daily weight).…”

“…Key issues for a clinical fluid-management investigation include the optimal fluid targets (eg, in/out fluid balance, central venous pressure, and daily weight). In preliminary work, the PALISI Network found 18 that cumulative fluid balance in pediatric ICU patients with ALI did not appear to have clinical utility.…”

“…Based on the small number of patients in the pediatric ALI descriptive reports, 6,7 one can conclude that a study of pediatric ALI/ ARDS would require the cooperation of multiple centers, most likely within a larger network such as PALISI, [5][6][7]17,18 the Collaborative Pediatric Critical Care Research Network, [19][20][21][22] or the Australian and New Zealand Intensive Care Society Clinical Trials Group. 2,23,24 The funding and institutional cooperation that such a study would require are quite substantial.…”

Intensivmedisinsk behandling av barn

“…Stort vaeskeoverskudd er verken vist å forsinke respiratoravvenning eller å gi økt reintuberingsrate (20). Systemiske steroider og inhalert racemisk adrenalin kan bidra til å redusere frekvensen av mislykket ekstubering.…”

Neonatal and Pediatric Respiratory Care: What Does the Future Hold?

“…5 Another key point for the success of RCTs includes the use of established networks to efficiently and effectively share resources and to draw from a larger population base. Examples of such established networks include the Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Network, [5][6][7][8][9] the Collaborative Pediatric Critical Care Research Network(CPCCRN), [10][11][12][13] and the Australian and New Zealand Intensive Care Society (ANZICS) Clinical Trials Group. [14][15][16] Among such networks, as well as in general, Curley reminded us to choose our collaborators wisely, based on credibility, cooperation, availability, and a track record of success.…”