Fluid Balance Is Associated with Clinical Outcomes and Extravascular Lung Water in Children with Acute Asthma Exacerbation.
RATIONALE: The effects of fluid administration during acute asthma exacerbation are likely unique in this patient population: highly negative inspiratory intrapleural pressure resulting from increased airway resistance may interact with excess fluid administration to favor the accumulation of extravascular lung water, leading to worse clinical outcomes.
OBJECTIVES: Investigate how fluid balance influences clinical outcomes in children hospitalized for asthma exacerbation.
METHODS: We analyzed the association between fluid overload and clinical outcomes in a retrospective cohort of children admitted to an urban children's hospital with acute asthma exacerbation. These findings were validated in two cohorts: a matched retrospective and a prospective observational cohort. Finally, ultrasound imaging was used to identify extravascular lung water and investigate the physiological basis for the inferential findings.
MEASUREMENTS AND MAIN RESULTS: In the retrospective cohort, peak fluid overload [(fluid input - output)/weight] is associated with longer hospital length of stay, longer treatment duration, and increased risk of supplemental oxygen use (P values
CONCLUSIONS: Excess volume administration leading to fluid overload in children with acute asthma exacerbation is associated with increased extravascular lung water and worse clinical outcomes.
|Year of Publication
Am J Respir Crit Care Med
2018 05 01
|PubMed Central ID
U01 AI110397 / AI / NIAID NIH HHS / United States
K23 HL138162 / HL / NHLBI NIH HHS / United States
R01 AI073964 / AI / NIAID NIH HHS / United States
T32 HD040128 / HD / NICHD NIH HHS / United States
K12 HD047349 / HD / NICHD NIH HHS / United States
UL1 TR001102 / TR / NCATS NIH HHS / United States
K24 AI106822 / AI / NIAID NIH HHS / United States