Fluid overload in newborns undergoing abdominal surgery: a retrospective study

Area of Science:

• Neonatal surgery
• Pediatric critical care
• Fluid balance management

Background:

• Fluid management in neonates undergoing surgery presents challenges due to difficulties in assessing volume status and significant fluid shifts.
• Fluid overload in this population is associated with increased risks of neonatal morbidity and mortality.

Purpose of the Study:

• To determine the prevalence of fluid overload in infants undergoing abdominal surgery.
• To evaluate the association between fluid overload and adverse outcomes in this patient group.

Main Methods:

• A retrospective cohort study included infants who underwent abdominal surgery at a tertiary perinatal center from January 2017 to June 2019.
• Fluid balance was assessed by monitoring the maximum percentage change in body weight at postoperative days 3 and 7.

Main Results:

• Sixty infants were studied, with a median gestational age of 29 weeks.
• Actual fluid intake exceeded prescribed amounts in the first 7 postoperative days.
• A 1% increase in body weight within 3 postoperative days correlated with a 0.6-day increase in invasive ventilatory support, even after adjusting for gestational age.

Conclusions:

• Fluid overload in the initial 3 postoperative days is associated with increased need for ventilatory support in infants.
• Optimizing fluid management strategies is essential for improving surgical outcomes in newborns.