Wyatt, Natalie;
Norman, Karen;
Ryan, Kate;
Shenoy, Mohan;
Malina, Michal;
Weerassoriya, Lasanthi;
Merritt, Jack;
... Hayes, Wesley; + view all
(2022)
Perioperative fluid management and associated complications in children receiving kidney transplants in the UK.
Pediatric Nephrology
10.1007/s00467-022-05690-3.
(In press).
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Abstract
Background: Intravenous fluid administration is an essential part of perioperative care for children receiving a kidney transplant. There is a paucity of evidence to guide optimal perioperative fluid management. This study aimed to identify the volume of perioperative fluids administered across 5 UK paediatric kidney transplant centres and explore associations between fluid volume administered, graft function, and fluid-related adverse events. Methods: Data were collected from five UK paediatric kidney transplant centres on perioperative fluid volumes administered, and incidence of pulmonary oedema, systemic hypertension, and requirement for intensive care support. Children < 18 years of age who received a kidney-only transplant between 1st January 2020 and 31st December 2021 were included. Results: Complete data from 102 children were analysed. The median total volume of fluid administered in 72 h was 377 ml/kg (IQR 149 ml/kg) with a high degree of variability. A negative relationship between total fluid volume administered and day 7 eGFR was noted (p < 0.001). Association between urine volume post-transplant and day 7 eGFR was also negative (p < 0.001). Adverse events were frequent but no significant difference was found in the fluid volume administered to those who developed an adverse event, vs those who did not. Conclusions: This study describes a high degree of variability in perioperative fluid volumes administered to children receiving kidney transplants. Both fluid volume and urine output were negatively associated with short-term graft function. These data contrast traditional interpretation of high urine output as a marker of graft health, and highlight the need for prospective clinical trials to optimise perioperative fluid administration for this group. Graphical Abstract: A higher resolution version of the Graphical abstract is available as Supplementary information [Figure not available: see fulltext.].
Type: | Article |
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Title: | Perioperative fluid management and associated complications in children receiving kidney transplants in the UK |
Location: | Germany |
Open access status: | An open access version is available from UCL Discovery |
DOI: | 10.1007/s00467-022-05690-3 |
Publisher version: | https://doi.org/10.1007/s00467-022-05690-3 |
Language: | English |
Additional information: | © 2022 Springer Nature Switzerland AG. This article is licensed under a Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/). |
Keywords: | Paediatric kidney transplant, Fluid, Graft survival, Pulmonary oedema, Hypertension, Oxygen requirement, PICU |
UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Developmental Biology and Cancer Dept UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences |
URI: | https://discovery.ucl.ac.uk/id/eprint/10155850 |
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