Positive fluid balance is associated with death and severity of brain injury in neonates with hypoxic–ischemic encephalopathy

Objective To investigate the association between fluid balance during therapeutic hypothermia (TH) and severity of brain injury on magnetic resonance imaging (MRI) in neonates with hypoxic–ischemic encephalopathy (HIE). Study design This is a secondary analysis of data from a prospective observation...

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Bibliographic Details
Published in:Journal of perinatology 2021-06, Vol.41 (6), p.1331-1338
Main Authors: Ottolini, Katherine M., Basu, Sudeepta K., Herrera, Nicole, Govindan, Vedavalli, Mashat, Suleiman, Vezina, Gilbert, Ridore, Michelande, Bost, James, Chang, Taeun, Massaro, An N.
Format: Article
Language:English
Subjects:
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Brain
Brain damage
Brain Injuries
Brain injury
Death
Diseases
Encephalopathy
Head injuries
Health aspects
Humans
Hypothermia
Hypoxia
Hypoxia-Ischemia, Brain
Infant, Newborn
Infants (Newborn)
Injuries
Ischemia
Magnetic resonance imaging
Medicine
Medicine & Public Health
Mortality
Neonates
Neuroimaging
Newborn babies
Osmoregulation
Patient outcomes
Pediatric research
Pediatric Surgery
Pediatrics
Prognosis
Secondary analysis
Traumatic brain injury
Water-Electrolyte Balance
Water-electrolyte balance (Physiology)
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Summary:Objective To investigate the association between fluid balance during therapeutic hypothermia (TH) and severity of brain injury on magnetic resonance imaging (MRI) in neonates with hypoxic–ischemic encephalopathy (HIE). Study design This is a secondary analysis of data from a prospective observational study in neonates with HIE. Daily net positive fluid balance during TH was investigated for association with the adverse primary outcome of death or moderate-to-severe brain injury on MRI using multivariable logistic regression. Results Of the 150 neonates included, 50 suffered adverse outcome and had significantly higher net positive fluid balance (53 vs. 19 ml/kg/day, p  25 ml/kg/day) at 24 hours of TH had 3.4 (95% CI 1.3–9) times higher odds of adverse outcome. Conclusions Positive fluid balance during TH in neonates with HIE is independently associated with death or moderate-to-severe brain injury on MRI.
ISSN:0743-8346
1476-5543
DOI:10.1038/s41372-021-00988-w