Abstract | BACKGROUND: Fluid restriction has been reported to improve survival of infants without chronic lung disease (CLD), but it remains unknown whether it reduces CLD in a population at high risk of CLD routinely exposed to antenatal steroids and postnatal surfactant without increasing other adverse outcomes. AIM: To investigate the impact of fluid restriction on the outcome of ventilated, very low birthweight infants. STUDY DESIGN: A randomised trial of two fluid input levels in the perinatal period was performed. A total of 168 ventilated infants (median gestational age 27 weeks (range 23-33)) were randomly assigned to receive standard volumes of fluid (60 ml/kg on day 1 progressing to 150 ml/kg on day 7) or be restricted to about 80% of standard input. RESULTS: Similar proportions of infants on the two regimens had CLD beyond 28 days (56% v 51%) and 36 weeks post conceptional age (26% v 25%), survived without oxygen dependency at 28 days (31% v 27%) and 36 weeks post conceptional age (58% v 52%), and developed acute renal failure. There were no statistically significant differences between other outcomes, except that fewer of the restricted group (19% v 43%) required postnatal steroids (p < 0.01). In the trial population overall, duration of oxygen dependency related significantly to the colloid (p < 0.01), but not crystalloid, input level; after adjustment for specified covariates, the hazard ratio was 1.07 (95% confidence interval 1.02 to 1.13). CONCLUSIONS: In ventilated, very low birthweight infants, fluid restriction in the perinatal period neither reduces CLD nor increases other adverse outcomes. Colloid infusion, however, is associated with increased duration of oxygen dependency.
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Authors | V Kavvadia, A Greenough, G Dimitriou, R Hooper |
Journal | Archives of disease in childhood. Fetal and neonatal edition
(Arch Dis Child Fetal Neonatal Ed)
Vol. 83
Issue 2
Pg. F91-6
(Sep 2000)
ISSN: 1359-2998 [Print] England |
PMID | 10952699
(Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Chemical References |
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Topics |
- Acute Kidney Injury
(etiology)
- Chronic Disease
- Colloids
- Disease-Free Survival
- Female
- Fluid Therapy
(adverse effects, methods)
- Glucocorticoids
(therapeutic use)
- Humans
- Infant, Newborn
- Infant, Very Low Birth Weight
- Lung Diseases
(etiology, therapy)
- Male
- Respiration, Artificial
(methods)
- Treatment Outcome
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