Evidence map›Paper›PMID 36066771›Full record

Observational studyPediatric nephrology (Berlin, Germany)2023

Assessment of fluid balance after neonatal cardiac surgery: a description of intake/output vs. weight-based methods.

Tara M Neumayr, Jeffrey A Alten, David K Bailly, Priya N Bhat, Katie L Brandewie, J Wesley Diddle, Muhammad Ghbeis, Catherine D Krawczeski, Kenneth E Mah, Tia T Raymond and 4 more

Abstract readObservational Study
PubMed Publisher
In one paragraph

Observational study in Pediatric nephrology (Berlin, Germany), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
3.3field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 15 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors at 11 institutions in 1 country.

Tara M NeumayrDepartment of Pediatrics, Divisions of Pediatric Critical Care Medicine and Pediatric Nephrology, Washington University School of Medicine, St. Louis, MO, USA. neumayr_t@wustl.edu.
Jeffrey A AltenUniversity of Cincinnati College of Medicine, The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
David K BaillyDepartment of Pediatrics, Division of Pediatric Critical Care, University of Utah, Salt Lake City, UT, USA.
Priya N BhatDepartment of Pediatrics, Sections of Critical Care Medicine and Cardiology, Texas Children's Hospital and Baylor College of Medicine, Houston, TX, USA.
Katie L BrandewieUniversity of Cincinnati College of Medicine, The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
J Wesley DiddleDivision of Cardiac Critical Care Medicine, Children's National Hospital, Washington, DC, USA.
Muhammad GhbeisDivision of Cardiovascular Critical Care, Department of Cardiology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
Catherine D KrawczeskiNationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, OH, USA.
Kenneth E MahStanford University School of Medicine, Palo Alto, CA, USA.
Tia T RaymondPediatric Cardiac Intensive Care, Medical City Children's Hospital, Dallas, TX, USA.
Garrett ReichleUniversity of Michigan, Ann Arbor, MI, USA.
Huaiyu ZangUniversity of Cincinnati College of Medicine, The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
David T SelewskiDepartment of Pediatrics, Medical University of South Carolina, Charleston, SC, USA.
NEPHRON Investigators
Cincinnati Children's Hospital Medical Center · USBaylor College of Medicine · USBoston Children's Hospital · USChildren's National · USMedical City Children's Hospital · USMedical University of South Carolina · USNationwide Children's Hospital · USPalo Alto University · USUniversity of Michigan · USUniversity of Utah · USWashington University in St. Louis · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundFluid overload associates with poor outcomes after neonatal cardiac surgery, but consensus does not exist for the most clinically relevant method of measuring fluid balance (FB). While weight change-based FB (FB-W) is standard in neonatal intensive care units, weighing infants after cardiac surgery may be challenging. We aimed to identify characteristics associated with obtaining weights and to understand how intake/output-based FB (FB-IO) and FB-W compare in the early postoperative period in this population.

methodsObservational retrospective study of 2235 neonates undergoing cardiac surgery from 22 hospitals comprising the NEonatal and Pediatric Heart and Renal Outcomes Network (NEPHRON) database.

resultsForty-five percent (n = 998) of patients were weighed on postoperative day (POD) 2, varying from 2 to 98% among centers. Odds of being weighed were lower for STAT categories 4 and 5 (OR 0.72; 95% CI 0.53-0.98), cardiopulmonary bypass (0.59; 0.42-0.83), delayed sternal closure (0.27; 0.19-0.38), prophylactic peritoneal dialysis use (0.58; 0.34-0.99), and mechanical ventilation on POD 2 (0.23; 0.16-0.33). Correlation between FB-IO and FB-W was weak for every POD 1-6 and within the entire cohort (correlation coefficient 0.15; 95% CI 0.12-0.17). FB-W measured higher than paired FB-IO (mean bias 12.5%; 95% CI 11.6-13.4%) with wide 95% limits of agreement (- 15.4-40.4%).

conclusionsWeighing neonates early after cardiac surgery is uncommon, with significant practice variation among centers. Patients with increased severity of illness are less likely to be weighed. FB-W and FB-IO have weak correlation, and further study is needed to determine which cumulative FB metric most associates with adverse outcomes. A higher resolution version of the Graphical abstract is available as Supplementary information.

Indexed as

Cardiac Surgical ProceduresWater-Electrolyte ImbalanceCardiopulmonary BypassChildHumansInfantInfant, NewbornRetrospective StudiesWater-Electrolyte BalanceCardiac surgeryFluid overloadNeonateWeight

Identifiers

PMID36066771
OpenAlexW4294733769

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.