| Title |
Fluid overload independent of acute kidney injury predicts poor outcomes in neonates following congenital heart surgery
|
|---|---|
| Published in |
Pediatric Nephrology, November 2017
|
| DOI | 10.1007/s00467-017-3818-x |
| Pubmed ID | |
| Authors |
Kenneth E. Mah, Shiying Hao, Scott M. Sutherland, David M. Kwiatkowski, David M. Axelrod, Christopher S. Almond, Catherine D. Krawczeski, Andrew Y. Shin |
| Abstract |
Fluid overload (FO) is common after neonatal congenital heart surgery and may contribute to mortality and morbidity. It is unclear if the effects of FO are independent of acute kidney injury (AKI). This was a retrospective cohort study which examined neonates (age < 30 days) who underwent cardiopulmonary bypass in a university-affiliated children's hospital between 20 October 2010 and 31 December 2012. Demographic information, risk adjustment for congenital heart surgery score, surgery type, cardiopulmonary bypass time, cross-clamp time, and vasoactive inotrope score were recorded. FO [(fluid in-out)/pre-operative weight] and AKI defined by Kidney Disease Improving Global Outcomes serum creatinine criteria were calculated. Outcomes were all-cause, in-hospital mortality and median postoperative hospital and intensive care unit lengths of stay. Overall, 167 neonates underwent cardiac surgery using cardiopulmonary bypass in the study period, of whom 117 met the inclusion criteria. Of the 117 neonates included in the study, 76 (65%) patients developed significant FO (>10%), and 25 (21%) developed AKI ≥ Stage 2. When analyzed as FO cohorts (< 10%,10-20%, > 20% FO), patients with greater FO were more likely to have AKI (9.8 vs. 18.2 vs. 52.4%, respectively, with AKI ≥ stage 2; p = 0.013) and a higher vasoactive-inotrope score, and be premature. In the multivariable regression analyses of patients without AKI, FO was independently associated with hospital and intensive care unit lengths of stay [0.322 extra days (p = 0.029) and 0.468 extra days (p < 0.001), respectively, per 1% FO increase). In all patients, FO was also associated with mortality [odds ratio 1.058 (5.8% greater odds of mortality per 1% FO increase); 95% confidence interval 1.008,1.125;p = 0.032]. Fluid overload is an important independent contributor to outcomes in neonates following congenital heart surgery. Careful fluid management after cardiac surgery in neonates with and without AKI is warranted. |
X Demographics
The data shown below were collected from the profiles of 12 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 3 | 25% |
| Iceland | 1 | 8% |
| Brazil | 1 | 8% |
| Canada | 1 | 8% |
| Unknown | 6 | 50% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 7 | 58% |
| Scientists | 4 | 33% |
| Science communicators (journalists, bloggers, editors) | 1 | 8% |
Mendeley readers
The data shown below were compiled from readership statistics for 59 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 59 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Bachelor | 10 | 17% |
| Student > Master | 9 | 15% |
| Other | 7 | 12% |
| Researcher | 7 | 12% |
| Student > Postgraduate | 4 | 7% |
| Other | 7 | 12% |
| Unknown | 15 | 25% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 26 | 44% |
| Nursing and Health Professions | 4 | 7% |
| Biochemistry, Genetics and Molecular Biology | 3 | 5% |
| Psychology | 3 | 5% |
| Engineering | 2 | 3% |
| Other | 3 | 5% |
| Unknown | 18 | 31% |
Attention Score in Context
This research output has an Altmetric Attention Score of 7. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 14 October 2018.
All research outputs
#5,557,583
of 25,918,104 outputs
Outputs from Pediatric Nephrology
#1,006
of 4,197 outputs
Outputs of similar age
#90,260
of 341,381 outputs
Outputs of similar age from Pediatric Nephrology
#16
of 63 outputs
Altmetric has tracked 25,918,104 research outputs across all sources so far. Compared to these this one has done well and is in the 78th percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 4,197 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 5.3. This one has done well, scoring higher than 75% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 341,381 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 73% of its contemporaries.
We're also able to compare this research output to 63 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 74% of its contemporaries.