Positive cumulative fluid balance at 72 h is associated with adverse outcomes following acute pediatric thermal injury

Nagpal, Ashish; Clingenpeel, Melissa-Moore; Thakkar, Rajan K.; Fabia, Renata; Lutmer, Jeffrey

doi:10.1016/j.burns.2018.01.018

Cited by 12 publications

(4 citation statements)

References 23 publications

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“…The baseline cohort (those without PMV) had a higher proportion of males (81% vs 71%, p = 0.007) and higher proportion of explosive injuries (52% vs 41%; p < 0.001). Median Injury Severity Scores (ISS) were lower in the baseline cohort versus the MV group (13 [IQR 9-19] vs 20 [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25]; p < 0.001) (Table 1). The baseline cohort had a lower proportion with serious injuries to the thorax (22% vs 29%, p = 0.04) and the skin (11% vs 34%; p < 0.001).…”

Section: Resultsmentioning

confidence: 99%

“…Burns occur in approximately 8–10% of blast injuries in combat trauma (21), and respiratory failure is the leading cause of death in burn injured patients (22), which is consistent with our current findings. A consideration within the burn-trauma cohort is that overresuscitation of fluids can lead to complications such as PMV and longer ICU stay (23). In our study, we have been able to identify a significant association between the volume of fluid used in resuscitation—whether crystalloid or colloid—and greater odds of developing PMV.…”

Section: Discussionmentioning

confidence: 99%

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Prolonged Mechanical Ventilation in Pediatric Trauma Patients in a Combat Zone

Moulton

Schauer

Borgman

2022

Pediatric Critical Care Medicine

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It is well known that polytrauma can lead to acute lung injury. Respiratory failure has been previously observed in combat trauma, but not reported in children, who account for over 11% of bed days at deployed Military Treatment Facilities (MTFs) using significant resources. We seek to identify risk factors associated with prolonged mechanical ventilation (PMV) which is important in resource planning and allocation in austere environments. DESIGN:Retrospective review of prospectively collected data within the United States Department of Defense Trauma Registry.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Prolonged Mechanical Ventilation in Pediatric Trauma Patients in a Combat Zone

Moulton

Schauer

Borgman

2022

Pediatric Critical Care Medicine

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“…The amount of fluid administrated in the previously mentioned study could be attributed for its inclusion criteria which are presence of inhalational injury, TBSA>30% and age less than 48 months. Also in Napgal et al, although they started resuscitation of their cases using 3-4ml lactated ringer/kg/% TBSA but 56% of their patients received greater than 6ml/kg/ TBSA in first day resuscitation [8]. This could also be attributed to the inclusion criteria of the study as patients with inhalational injury were not excluded.…”

Section: Discussionmentioning

confidence: 99%

A Model for Validation of Parkland Formula for Resuscitation of Major Burn in Pediatrics

Ahmed

Badawy

Sayed

et al. 2022

The Egyptian Journal of Plastic and Reconstructive Surgery

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“…However, over time the initial benefit of fluid therapy can lead to fluid accumulation and tissue edema, and this can exacerbate organ dysfunction (12). Several observational studies found an association between the positive fluid balance (FB) and poor outcomes in critically ill patients with septic AKI (9,(13)(14)(15). Optimizing fluid status is essential for patients with excess fluid accumulation but is difficult to achieve when the patients develop AKI.…”

Section: Introductionmentioning

confidence: 99%

Impact of Cumulative Fluid Balance During Continuous Renal Replacement Therapy on Mortality in Patients With Septic Acute Kidney Injury: A Retrospective Cohort Study

et al. 2021

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Background: The clinicians often use continuous renal replacement therapy (CRRT) for the fluid management of patients with septic acute kidney injury (AKI). However, there is limited knowledge of the effects of changes in fluid balance (FB) on CRRT and its association with outcomes in patients with septic AKI.Objective: This study aimed to determine the association of cumulative FB (CFB) during treatment with 28-day all-cause mortality in the patients with septic AKI who require CRRT.Methods: This retrospective observational study examined patients who received CRRT due to septic AKI in a mixed intensive care unit (ICU) of a tertiary teaching hospital between January 2015 and December 2018. The patients were divided into three groups—negative FB, even FB, and positive FB—based on the CFB during CRRT. The primary outcome was 28-day all-cause mortality.Results: We examined 227 eligible patients and the mean age was 62.4 ± 18.3 years. The even FB group had a significantly lower 28-day mortality (43.0%, p = 0.007) than the positive FB group (72.7%) and the negative FB group (54.8%). The unadjusted and adjusted Cox regression models indicated that the positive FB group had an increased risk for 28-day all-cause mortality relative to the even FB group. A restricted cubic splines model indicated a J-shaped association between the CFB and 28-day all-cause mortality in the unadjusted model.Conclusion: Among the critically ill patients with septic AKI who require CRRT, those with positive FB had a higher mortality rate than those with even FB.

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Positive cumulative fluid balance at 72 h is associated with adverse outcomes following acute pediatric thermal injury

Cited by 12 publications

References 23 publications

Prolonged Mechanical Ventilation in Pediatric Trauma Patients in a Combat Zone

Prolonged Mechanical Ventilation in Pediatric Trauma Patients in a Combat Zone

A Model for Validation of Parkland Formula for Resuscitation of Major Burn in Pediatrics

Impact of Cumulative Fluid Balance During Continuous Renal Replacement Therapy on Mortality in Patients With Septic Acute Kidney Injury: A Retrospective Cohort Study

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