Impact of Fluid Resuscitation on Clinical Outcomes for Very Low Birth Weight infants in Neonatal Intensive Care Unit

Background: Administration of fluid resuscitation (bolus) in very low birth weight (VLBW) infants is a common practice in NICU. There are no specific guidelines or indications for fluid resuscitation in VLBW infants. For older children, the FEAST Trial demonstrated increased risk of mortality with s...

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Bibliographic Details
Published in:Pediatrics (Evanston) 2019-08, Vol.144 (2_MeetingAbstract), p.647-647
Main Authors: Bakshi, Shubham, Singh, Rachana, Vaidya, Ruben, Koerner, Taylor, Knee, Alex
Format: Article
Language:English
Subjects:
Acidosis
Aneurysms
Apgar score
Birth weight
Children
Clinical outcomes
Gestation
Gestational age
Hemorrhage
Hypotension
Indication
Infants
Intensive care
Intravenous administration
Low birth weight
Lung diseases
Metabolic acidosis
Mortality
Neonates
Newborn babies
Pediatrics
Perfusion
Steroids
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Summary:Background: Administration of fluid resuscitation (bolus) in very low birth weight (VLBW) infants is a common practice in NICU. There are no specific guidelines or indications for fluid resuscitation in VLBW infants. For older children, the FEAST Trial demonstrated increased risk of mortality with saline bolus as compared to controls in African children with severe infection, challenging the importance of fluid resuscitation in children with shock who do not have hypotension. It is plausible that empiric fluid resuscitation may be detrimental for VLBW infants as well, especially when there is no well-defined indication for fluid replacement. Objective: To study the association between intravenous fluid resuscitation in the first 48 hours of life and respiratory, cardiac, neurologic and mortality outcomes in VLBW infants. Design/Methods: Retrospective cohort study of all preterm infants, born < or equal to 34 weeks of gestation with birth weight < or equal to 1500 grams at a single Level III NICU from 1/1/2008 through 12/31/2013. Infants were divided into two groups based on whether or not they received fluid resuscitation which was defined as receiving at least one 10 mL/kg fluid bolus within the first 48 hours of life. Outcome data were collected for prevalence of chronic lung disease (CLD), patent ductus arteriosus (PDA), intraventricular hemorrhage (IVH), and mortality in the two groups. The outcomes were further stratified by gestational age:
ISSN:0031-4005
1098-4275
DOI:10.1542/peds.144.2MA7.647