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- Title
Post‐operative fluid overload as a predictor of hospital and long‐term outcomes in a pediatric heart transplant population.
- Authors
Anderson, Nicole M.; Bond, Gwen Y.; Joffe, Ari R.; MacDonald, Christine; Robertson, Charlene; Urschel, Simon; Morgan, Catherine J.
- Abstract
Background: Pediatric patients undergoing heart transplant have a number of factors predisposing them to become fluid‐overloaded, including capillary leak syndrome. Capillary leak and FO are associated with organ injury and may influence both short‐ and long‐term outcomes. This study aimed to 1) determine the extent, timing, and predictors of post‐operative FO and 2) investigate the association of FO with clinically important outcomes. Methods: Between 2000 and 2012, 70 children less than 6 years old had a heart transplant at our institution. This was a secondary analysis of data from an ongoing prospective cohort study. Results: FO, defined as cumulative fluid balance greater than 10% of body weight in the first 5 post‐operative days, occurred in 16/70 patients (23%); 7 of these had more than 20% FO. Shorter donor ischemic time and longer cardiopulmonary bypass time were independently associated with increased risk of FO. FO >20% was a statistically significant independent predictor of mortality (P =.005), ventilation time, and PICU length of stay. There was no statistically significant association between identified neurodevelopment domains and FO. Conclusions: Our single‐center experience demonstrates that FO was common after pediatric heart transplant and was associated with worse clinical outcomes. FO is a potentially modifiable factor, and research is needed to better determine risk factors and whether intervention to reduce FO can improve outcomes in pediatric heart transplant patients.
- Subjects
HEART transplantation; HEART transplant recipients; CAPILLARY leak syndrome; CHILD patients; TREATMENT effectiveness; CARDIOPULMONARY bypass
- Publication
Pediatric Transplantation, 2021, Vol 25, Issue 3, p1
- ISSN
1397-3142
- Publication type
Article
- DOI
10.1111/petr.13897