Table 3.
Impact of FO on various outcome variables in the given pediatric populations.
| Author; Year | Outcome measures considered | Observations |
|---|---|---|
| RENAL REPLACEMENT THERAPY | ||
| Sutherland et al. (41) | Mortality | FO at CRRT initiation with raised odds [aOR 1.03] for mortality [≥20, 10–20, <10% FO groups with 65, 43, and 29% mortality respectively]. |
| Hayes et al. (42) | Mortality | Median FO at CRRT initiation was 7.3% in survivors vs. 22.3% in non-survivors. |
| Goldstein et al. (43) | Mortality | Mean FO at CRRT initiation was 25.4% in survivors vs. 14.2% in non-survivors. |
| Gillespie et al. (44) | Mortality | ≥10%FO at CRRT initiation significantly increased the risk of mortality [HR 3.02, 95%CI 1.5–6.1; p = 0.002]. |
| Foland et al. (45) | Mortality | Median FO was significantly lower in survivors vs. non-survivors [7.8 vs. 15.5%; p = 0.01]. |
| Goldstein et al. (12) | Mortality | Mean FO was significantly lower in survivors [16.4%] than non-survivors [34%] after controlling for illness severity [p = 0.03]. |
| EXTRACORPOREAL MEMBRANE OXYGENATION | ||
| Selewski et al. (49) | Mortality | Median FO at CRRT initiation significantly lower in survivors compared to non-survivors [24.5 vs. 38%, p = 0.006]. FO<10% at CRRT initiation was associated with reduced odds of mortality [aOR 0.02, 95%CI 0.00–0.07, p = 0.035]. |
| Swaniker et al. (68) | Mortality | Mean BW decreased about 5 ± 2% in survivors vs. increasing 11 ± 5% [p < 0.001] in non-survivors. |
| Selewski et al. (40) | Mortality | Increased ECMO mortality was associated with >20% FO at ECMO initiation (35.2 vs. 22%; p = 0.0003). During ECMO, a peak FO >30% was associated with increased ECMO mortality (34 vs. 15.9%; p < 0.0001). |
| CARDIAC SURGERY | ||
| Lex et al. (54) | Mortality, LCOS, LMV | >5%FO was independently associated with mortality [aOR, 1.14,95%CI 1.008–1.303; p = 0.041] and LCOS [1.21,95% CI 1.12–1.30, p = 0.001]. |
| Sampaio et al. (56) | LMV, LOS | Maximum cumulative fluid balance [6.82 %(IQR 3.28–11.71)] was associated with duration of MV [adjusted β coefficient = 0.53, CI 0.38–0.66, p < 0.001], LOS in PICU [Spearman's ρ = 0.45, p < 0.001]. |
| Piggottv et al. (57) | LOS, LMV, mortality | >15%FO was associated with higher mortality [31% vs. 0%; p < 0.001], greater median LOS and LMV [39 vs. 76 days, p = 0.03 and 8 vs. 25 days, p < 0.001 respectively]. |
| Seguin et al. (58) | LOS, LMV, OI | Peak cumulative FO during day 2 predicted longer LOS [aHR 0.95, 95%CI 0.92–0.99, p = 0.009], longer MV [aHR 0.97, 95%CI 0.94–0.99, p = 0.03]. |
| Hassinger et al. (59) | LOS, LMV, inotropic support, AKI | ≥5%FO was independently associated with prolonged need for MV, LOS, inotropic support [p < 0.001] and post CPB-AKI [p = 0.023]. |
| Hazlev et al. (16) | LOS, LMV, mortality | Higher mean max FO by both FB [12 ± 10 vs. 6 ± 4%, p = 0.03] and weight based [24 ± 15 vs. 14 ± 8%, p = 0.02] methods was associated with composite poor outcome. |
| Basu et al. (29) | AKI | Infants who developed AKI after surgery had higher fluid balance [148 ± 125 vs. 115 ± 117ml/d, p = 0.016]. |
| Grist et al. (55) | Mortality, LOS | Mean positive balance in non-survivors was 18ml/kg. FO was associated with increased mortality [aOR1.73 (95% CI 1.01–2.96)] and longer LOS [p < 0.05]. |
| NEONATES | ||
| Lee and Cho (69) | Mortality | Neonates with ≥30% FO at the time of CRRT initiation had lower survival rates [p = 0.009]. |
| Askenazi et al. (67) | AKI | Median weight gain at D3 of life was higher in the AKI vs. non AKI cohort [8.2% IQR (4.4–21.6%) vs. −4% (IQR−6.5 to 0.0%) (p < 0.001)]. Infants with AKI had lower survival rates than those without AKI [72 vs. 100 % (p < 0.02)]. |
| Askenazi et al. (70) | MV/death, AKI | Infants with AKI [30%] had a higher max% weight change in the first 4 days of life [p = 0.05] and were at higher risk of death/MV at D28 [p < 0.03]. |
| RESPIRATORY TRACT DISEASE | ||
| Ingelse et al. (71) | LMV | Higher D3 CFB was independently associated with prolonged LMV [β = 0.166, p = 0.048]. |
| Sinitsky et al. (72) | OI, LMV | FO% had significant correlation with OI [Spearman ρ 0.318; p < 0.0001] and invasive ventilation days [ ρ 0.274; p < 0.0001]. |
| Willson et al. (32) | Mortality, VFDs, OI | Mean CFB in non-survivors was significantly higher than survivors [8.7 ± 9.5L/m2 vs. 1.2 ± 2.4L/m2; p < 0.001]. Higher CFB was significantly associated with fewer VFDs (p < 0.001) and higher OI [0.52 point increase in OSI for each L/m2 increase in FB; p = 0.011]. |
| Valentine et al. (73) | VFDs | Higher CFB at D3 was independently associated with fewer VFDs [p = 0.02]. |
| Arikan et al. (33) | LMV, PICU and hospital LOS | ≥15%FO were both independently associated with LMV [p = 0.004 and 0.01], PICU stay [p = 0.008 and 0.01] and hospital LOS [p = 0.02 and 0.04]. Peak total FO, OI and PELOD score in survivors and non-survivors were 13.7 ± 10.0 vs. 15.9 ± 10.3 (p = 0.45); 16.6 ± 17.6 vs. 31.5 ± 29.6 (p = 0.05) and 18.2 ± 7.6 vs. 20.9 ± 9.5 (p = 0.01) respectively. |
| Floriv et al. (74) | Mortality, VFDs | Positive FB (in increments of 10 mL/kg/24 h) was significantly associated with increased mortality [OR1.08, 95% CI 1.01–1.15, p = 0.02] and reduced VFDs [−0.21 (−0.39 to −0.04), p = 0.02]. |
| SEPSIS | ||
| Abulebda et al. (37) | Mortality | Median CFB in non-survivors was 19.5% vs. 6.5% in survivors [p < 0.001]. |
| Chen et al. (75) | Mortality | Both early FO and PICU-acquired daily FO of >5% were associated with mortality [aOR 1.20; 95%CI 1.08–1.33; p = 0.001; n = 202 and aOR = 5.47 per log increase; 95%CI 1.15-25.96; p = 0.032; n = 154]. Median values of early and acquired daily FO in survivors vs. non-survivors were 0.62% [−0.47 to 2.19] vs. 3.00% [−0.23 to 5.28] and 0.27% [1.66 to 4.61] vs. 4.27% [2.74 to 6.56] respectively. |
| MISCELLANEOUS | ||
| Li et al. (34) | Mortality, AKI | Early FO (>5% in first 24h) was independently associated with AKI (OR 1.34, p < 0.001) and mortality (OR 1.36, p < 0.001). Incidence of AKI and mortality in children with early FO was 18.8 vs. 4.2 and 15.6% vs. 2.6% respectively when compared to children with < 5%FO. |
| Bhaskar et al. (76) | Mortality | Early FO (>10% in 72h) [aOR 9.17, 95 %CI 2.22–55.57], its severity [aOR 1.11,1.05–1.19] and duration [aOR 1.61, 1.21–2.28] independently predicted mortality. Cases had significantly higher mortality than controls [26 vs. 6%; p = 0.003], even in the matched analysis [37 vs. 3 %; p = 0.002]. |
LOS-length of stay; LMV-length of mechanical ventilation; LCOS-low cardiac output syndrome; VFD-ventilator free days; aOR-adjusted odd ratio; HR-hazard ratio.