Fluid balance during PICU stay in children after cardiac surgery with cardiopulmonary bypass.
Each 1% rise in day-one fluid balance is associated with longer pediatric intensive care unit stay
Fluid balance during PICU stay in children after cardiac surgery with cardiopulmonary bypass.
Pediatric patients undergoing cardiac surgery are at risk for developing positive cumulative fluid balance (cumulative fluid balance).
Retrospective single center study of 200 consecutive children undergoing congenital heart surgery with cardiopulmonary bypass (cardiopulmonary bypass).
each 1% more fluid on day one, longer pediatric intensive care unit stay
A cumulative fluid balance POD1 ≥ 5% was observed in 36% of the patients.
Lower weight and longer cardiopulmonary bypass time were identified as explanatory variables for developing cumulative fluid balance POD1 ≥ 5%.
Patients with cumulative fluid balance POD1 ≥ 5% showed more acute kidney injury, higher vasoactive inotropic scores, and prolonged invasive ventilation and pediatric intensive care unit length of stay (LOS).
Furthermore, patients with cumulative fluid balance POD1 ≥ 5% had lower cardiac event free survival time (p < 0.001).
This study confirms that even a minor positive cumulative fluid balance ≥ 5% is common in pediatric cardiac patients and associated with adverse pediatric intensive care unit outcomes.
Lower body weight and prolonged cardiopulmonary bypass duration increased the risk for positive cumulative fluid balance, warranting close fluid monitoring.
Positive cumulative fluid balance was also associated with cardiac events during long-term follow-up and may help identify patients at increased risk for a complicated clinical trajectory, underscoring the importance of timely recognition and structured cardiac follow-up.