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Fluid overload independent of acute kidney injury predicts poor outcomes post congenital heart surgery.

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eMediNexus    20 November 2017

A new study published in Pediatric Nephrology aimed to determine whether the effects of fluid overload FO which is common after neonatal congenital heart surgery are independent of acute kidney injury AKI . In this retrospective cohort study neonates below 30 days of age who underwent cardiopulmonary bypass in a university affiliated children s hospital between 20 October 2010 and 31 December 2012 were examined. The results revealed that out of 117 neonates included in this study 65 developed significant FO 10 and 21 developed AKI 8805 Stage 2. Within the FO cohort those with greater FO had greater predisposition towards AKI a higher vasoactive inotrope score and were more likely to be premature. Among patients without AKI FO was independently associated with hospital and intensive care unit lengths of stay and 0.468 extra days respectively per 1 FO increase. Overall FO was also associated with mortality 5.8 greater odds of mortality per 1 FO increase. Hence it was concluded that fluid overload is an important independent contributor to outcomes in neonates following congenital heart surgery. It was stated that careful fluid management after cardiac surgery in neonates with and without AKI is essential.

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