Fluid Overload and Renal Angina Index at Admission Are Associated With Worse Outcomes in Critically Ill Children

Frontiers in Pediatrics
Sidharth K SethiRupesh Raina

Abstract

Objectives: We investigated the association of fluid overload and oxygenation in critically sick children, and their correlation with various outcomes (duration of ventilation, ICU stay, and mortality). We also assessed whether renal angina index (RAI) at admission can predict mortality or acute kidney injury (AKI) on day 3 after admission. Design and setting: Prospective study, pediatric intensive care in a tertiary hospital. Duration: June 2013-June 2014. Patients: Patients were included if they needed invasive mechanical ventilation for >24 h and had an indwelling arterial catheter. Patients with congenital heart disease or those who received renal replacement therapy (RRT) were excluded. Methods: Oxygenation index, fluid overload percent (daily, cumulative), RAI at admission and pediatric logistic organ dysfunction (PELOD) score were obtained in all critically ill children. KDIGO classification was used to define AKI, using both creatinine and urine output criteria. Admission data for determination of RAI included the use of vasopressors, invasive mechanical ventilation, percent fluid overload, and change in kidney function (estimated creatinine clearance). Univariable and multivariable approaches were used to assess the re...Continue Reading

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Citations

Jan 12, 2020·Indian Journal of Pediatrics·Sidharth Kumar SethiRupesh Raina
Jun 10, 2020·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Sainath RamanLuregn J Schlapbach
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Feb 7, 2020·The American Journal of Emergency Medicine·Holly R HansonRajit K Basu
Apr 29, 2021·Seminars in Dialysis·David Askenazi, Rajit K Basu
May 21, 2021·Pediatric Research·Sanjay WazirRupesh Raina
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Jan 13, 2022·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Sidharth Kumar SethiSanjay Wazir

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