Fluid Balance in the Critically Ill Child Section: 'How Bad Is Fluid in Neonates?'
| Autor: | Matthew W. Harer, Austin Rutledge, Jennifer G. Jetton, Heidi J. Murphy |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
kidney replacement therapy Mini Review continuous renal replacement therapy 030232 urology & nephrology Diuresis 030204 cardiovascular system & hematology Pediatrics RJ1-570 03 medical and health sciences 0302 clinical medicine Kidney Replacement Therapy Weight loss medicine Intensive care medicine fluid overload Balance (ability) Critically ill business.industry Confounding Acute kidney injury medicine.disease fluid balance Low birth weight acute kidney injury Pediatrics Perinatology and Child Health medicine.symptom neonate business |
| Zdroj: | Frontiers in Pediatrics Frontiers in Pediatrics, Vol 9 (2021) |
| ISSN: | 2296-2360 |
| Popis: | Fluid overload (FO) in neonates is understudied, and its management requires nuanced care and an understanding of the complexity of neonatal fluid dynamics. Recent studies suggest neonates are susceptible to developing FO, and neonatal fluid balance is impacted by multiple factors including functional renal immaturity in the newborn period, physiologic postnatal diuresis and weight loss, and pathologies that require fluid administration. FO also has a deleterious impact on other organ systems, particularly the lung, and appears to impact survival. However, assessing fluid balance in the postnatal period can be challenging, particularly in extremely low birth weight infants (ELBWs), given the confounding role of maternal serum creatinine (Scr), physiologic weight changes, insensible losses that can be difficult to quantify, and difficulty in obtaining accurate intake and output measurements given mixed diaper output. Although significant FO may be an indication for kidney replacement therapy (KRT) in older children and adults, KRT may not be technically feasible in the smallest infants and much remains to be learned about optimal KRT utilization in neonates. This article, though not a meta-analysis or systematic review, presents a comprehensive review of the current evidence describing the effects of FO on outcomes in neonates and highlights areas where additional research is needed. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|