早产儿急性肾损伤、液体平衡与脑室内出血风险

Acute kidney injury, fluid balance and risks of intraventricular hemorrhage in premature infants.

机构信息

East Tennessee State University, Johnson City, TN, USA.

University of Kentucky, Lexington, KY, USA.

出版信息

J Perinatol. 2020 Sep;40(9):1296-1300. doi: 10.1038/s41372-020-0613-5. Epub 2020 Feb 17.

DOI:10.1038/s41372-020-0613-5

PMID:32066840

Abstract

OBJECTIVE

Evaluate association between fluid balance and intraventricular hemorrhage (IVH).

STUDY DESIGN

Retrospective review of infants <30 weeks gestation admitted to Kentucky Children's Hospital Neonatal Intensive Care Unit.

RESULTS

Infants with acute kidney injury (AKI) had a 2.4-fold increased risk of IVH (OR 2.38, 95% CI 1.46-3.87) and a 3.5-fold increased risk of severe IVH (OR 3.45, 95% CI 1.98-6.04). Infants above birthweight on day 4 had a 1.9-fold increased risk of IVH (OR 1.86, 95% CI 1.05-3.27) and a 2.0-fold increased risk of severe IVH (OR 1.96, 95% CI 1.03-3.74). When controlling for confounding factors, infants with AKI or above birthweight on day 4 had a 4.6-fold (aOR 4.60, 95% CI 1.80-11.78) and 3.0-fold (aOR 2.96, 95% CI 1.01-8.65) increased risk of severe IVH, respectively.

CONCLUSION

Infants with AKI during the first week of life had a higher association of severe IVH even after controlling for confounding factors.

摘要

目的

评估液体平衡与脑室内出血（IVH）之间的关系。

研究设计

回顾性分析入住肯塔基儿童医院新生儿重症监护病房的<30 周龄婴儿。

结果

急性肾损伤（AKI）婴儿发生 IVH 的风险增加 2.4 倍（OR 2.38，95%CI 1.46-3.87），严重 IVH 的风险增加 3.5 倍（OR 3.45，95%CI 1.98-6.04）。第 4 天体重超过出生体重的婴儿发生 IVH 的风险增加 1.9 倍（OR 1.86，95%CI 1.05-3.27），发生严重 IVH 的风险增加 2.0 倍（OR 1.96，95%CI 1.03-3.74）。在控制混杂因素后，AKI 或第 4 天体重超过出生体重的婴儿发生严重 IVH 的风险分别增加 4.6 倍（校正比值比[aOR]4.60，95%CI 1.80-11.78）和 3.0 倍（aOR 2.96，95%CI 1.01-8.65）。