Association between fluid overload and mortality in newborns: a systematic review and meta-analysis

AbstractFluid overload (FO) is associated with higher rates of mortality and morbidity in pediatric and adult populations. The aim of this systematic review and meta-analysis was to investigate the association between FO and mortality in critically ill neonates. Systematic search of Ovid MEDLINE, EMBASE, Cochrane Library, trial registries, and gray literature from inception to January 2021. We included all studies that examined neonates admitted to neonatal intensive care units and described FO and outcomes of interest. We identified 17 observational studies with a total of 4772 critically ill neonates who met the inclusion criteria. FO was associated with higher mortality (OR, 4.95 [95% CI, 2.26 –10.87]), and survivors had a lower percentage of FO compared with nonsurvivors (WMD, − 4.33 [95% CI, − 8.34 to − 0.32]). Neonates who did not develop acute kidney injury (AKI) had lower FO compared with AKI patients (WMD, − 2.29 [95% CI, − 4.47 to − 0.10]). Neo nates who did not require mechanical ventilation on postnatal day 7 had lower fluid balance (WMD, − 1.54 [95% CI, − 2.21 to − 0.88]). FO is associated with higher mortality, AKI, and need for mechanical ventilation in critically ill neonates in the intensive care unit. Strict contr ol of fluid balance to prevent FO is essential.Graphical abstractA higher resolution version of the Graphical abstract is available as Supplementary information
Source: Pediatric Nephrology - Category: Urology & Nephrology Source Type: research