Use of Fenoldopam in Children with Congenital Heart Disease to Decrease Fluid Balance: A Retrospective, Descriptive...

Area of Science:

• Pediatric Cardiology
• Critical Care Medicine
• Pharmacology

Background:

• Children with congenital heart disease (CHD) often experience fluid balance challenges in the cardiac intensive care unit (CICU).
• Optimizing fluid management is crucial for improving outcomes in critically ill pediatric cardiac patients.

Purpose of the Study:

• To investigate the effect of fenoldopam on fluid balance in pediatric patients with CHD.
• To identify factors associated with a decrease in fluid balance during fenoldopam infusion.

Main Methods:

• Retrospective review of 46 pediatric patients in the CICU receiving fenoldopam infusion between January 2014 and December 2018.
• Analysis of demographic, clinical, laboratory, hemodynamic, and fluid balance data before and after fenoldopam initiation.
• Comparison of patient characteristics between those with and without a decrease in fluid balance.

Main Results:

• Fenoldopam infusion was associated with a statistically significant decrease in systolic and diastolic blood pressure.
• A majority of patients (74%) experienced a decrease in fluid balance, and 54% had decreased fluid input.
• Fenoldopam was not significantly associated with an increase in urine output, though 39% showed an increase.
• Higher baseline blood urea nitrogen levels were observed in patients with a decrease in fluid balance.

Conclusions:

• Fenoldopam administration in children with CHD is linked to reduced fluid balance and fluid input.
• The drug's effect on fluid balance may be influenced by factors such as baseline blood urea nitrogen levels.
• Further research is warranted to identify specific patient subgroups who may benefit most from fenoldopam for fluid management.