Early urine output monitoring in very preterm infants to predict in-hospital neonatal outcomes: a bicentric retrospective cohort study
Objective To evaluate whether urine output (UO), rarely assessed in the literature, is associated with relevant neonatal outcomes in very preterm infants, and which UO threshold may be the most clinically relevant.Design Retrospective cohort study.Setting Two Level IV neonatal intensive care units.P...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2023-01-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/13/1/e068300.full |
| _version_ | 1811176198023151616 |
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| author | Olivier Baud Valérie Biran Antoine Poncet Marie Saint-Faust Aurélie De Mul Alice Heneau Alexandra Wilhelm-Bals Paloma Parvex |
| author_facet | Olivier Baud Valérie Biran Antoine Poncet Marie Saint-Faust Aurélie De Mul Alice Heneau Alexandra Wilhelm-Bals Paloma Parvex |
| author_sort | Olivier Baud |
| collection | DOAJ |
| description | Objective To evaluate whether urine output (UO), rarely assessed in the literature, is associated with relevant neonatal outcomes in very preterm infants, and which UO threshold may be the most clinically relevant.Design Retrospective cohort study.Setting Two Level IV neonatal intensive care units.Patients Very preterm infants born between 240/7 and 296/7 weeks of gestation documented with eight UO measurements per day between postnatal day 1 and day 7.Main outcome measures Composite outcome defined as death before discharge, or moderate to severe bronchopulmonary dysplasia, or severe brain lesions. The association between this outcome and UO was studied using several UO thresholds.Results Among 532 infants studied, UO <1.0 mL/kg/hour for at least 24 consecutive hours was measured in 55/532 (10%) infants and the primary outcome was recorded in 25 patients. The association between a UO threshold <1.0 mL/kg/hour and the primary outcome was found marginally significant (crude OR 1.80, 95% CI 1.02 to 3.16, p=0.04). The primary outcome was recorded in 112/242 (46%) patients with a UO <2.0 mL/kg/hour and only 64/290 (22%) patients with a UO ≥2.0 mL/kg/hour (p<0.001). This UO threshold was found significantly associated with the primary outcome (crude OR 3.1, 95% CI 2.1 to 4.7, p<0.001), an association confirmed using a multivariate logistic regression model including baseline covariates (adjusted OR 3.7, 95% CI 2.2 to 6.4, p<0.001).Conclusion A UO <2 mL/kg/hour over 24 hours between postnatal day 1 and day 7 strongly predicts neonatal mortality or severe morbidities in very preterm infants. |
| first_indexed | 2024-04-10T19:48:22Z |
| format | Article |
| id | doaj.art-4f70f1b5168e44c8af20bdb6520321ee |
| institution | Directory Open Access Journal |
| issn | 2044-6055 |
| language | English |
| last_indexed | 2024-04-10T19:48:22Z |
| publishDate | 2023-01-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj.art-4f70f1b5168e44c8af20bdb6520321ee2023-01-28T16:00:09ZengBMJ Publishing GroupBMJ Open2044-60552023-01-0113110.1136/bmjopen-2022-068300Early urine output monitoring in very preterm infants to predict in-hospital neonatal outcomes: a bicentric retrospective cohort studyOlivier Baud0Valérie Biran1Antoine Poncet2Marie Saint-Faust3Aurélie De Mul4Alice Heneau5Alexandra Wilhelm-Bals6Paloma Parvex7Département de la Femme, de l`Enfant et de l`Adolescent, Service des soins intensifs pédiatriques et néonatals, Hôpitaux Universitaires de Genève, Geneve, SwitzerlandDépartement de Pédiatrie, Service de réanimation et médecine néonatales, Hopital Universitaire Robert Debré, Paris, FranceCentre de Recherche Clinique, Division d`épidémiologie clinique, Hôpitaux Universitaires de Genève, Geneva, SwitzerlandDépartement de la Femme, de l`Enfant et de l`Adolescent, Service des soins intensifs pédiatriques et néonatals, Hôpitaux Universitaires de Genève, Geneve, SwitzerlandDépartement de la Femme, de l`Enfant et de l`Adolescent, Service des soins intensifs pédiatriques et néonatals, Hôpitaux Universitaires de Genève, Geneve, SwitzerlandDépartement de Pédiatrie, Service de réanimation et médecine néonatales, Hopital Universitaire Robert Debré, Paris, FranceDépartement de la Femme, de l`Enfant et de l`Adolescent, Unité de néprologie pédiatrique, Hôpitaux Universitaires de Genève, Geneva, SwitzerlandDépartement de la Femme, de l`Enfant et de l`Adolescent, Unité de néprologie pédiatrique, Hôpitaux Universitaires de Genève, Geneva, SwitzerlandObjective To evaluate whether urine output (UO), rarely assessed in the literature, is associated with relevant neonatal outcomes in very preterm infants, and which UO threshold may be the most clinically relevant.Design Retrospective cohort study.Setting Two Level IV neonatal intensive care units.Patients Very preterm infants born between 240/7 and 296/7 weeks of gestation documented with eight UO measurements per day between postnatal day 1 and day 7.Main outcome measures Composite outcome defined as death before discharge, or moderate to severe bronchopulmonary dysplasia, or severe brain lesions. The association between this outcome and UO was studied using several UO thresholds.Results Among 532 infants studied, UO <1.0 mL/kg/hour for at least 24 consecutive hours was measured in 55/532 (10%) infants and the primary outcome was recorded in 25 patients. The association between a UO threshold <1.0 mL/kg/hour and the primary outcome was found marginally significant (crude OR 1.80, 95% CI 1.02 to 3.16, p=0.04). The primary outcome was recorded in 112/242 (46%) patients with a UO <2.0 mL/kg/hour and only 64/290 (22%) patients with a UO ≥2.0 mL/kg/hour (p<0.001). This UO threshold was found significantly associated with the primary outcome (crude OR 3.1, 95% CI 2.1 to 4.7, p<0.001), an association confirmed using a multivariate logistic regression model including baseline covariates (adjusted OR 3.7, 95% CI 2.2 to 6.4, p<0.001).Conclusion A UO <2 mL/kg/hour over 24 hours between postnatal day 1 and day 7 strongly predicts neonatal mortality or severe morbidities in very preterm infants.https://bmjopen.bmj.com/content/13/1/e068300.full |
| spellingShingle | Olivier Baud Valérie Biran Antoine Poncet Marie Saint-Faust Aurélie De Mul Alice Heneau Alexandra Wilhelm-Bals Paloma Parvex Early urine output monitoring in very preterm infants to predict in-hospital neonatal outcomes: a bicentric retrospective cohort study BMJ Open |
| title | Early urine output monitoring in very preterm infants to predict in-hospital neonatal outcomes: a bicentric retrospective cohort study |
| title_full | Early urine output monitoring in very preterm infants to predict in-hospital neonatal outcomes: a bicentric retrospective cohort study |
| title_fullStr | Early urine output monitoring in very preterm infants to predict in-hospital neonatal outcomes: a bicentric retrospective cohort study |
| title_full_unstemmed | Early urine output monitoring in very preterm infants to predict in-hospital neonatal outcomes: a bicentric retrospective cohort study |
| title_short | Early urine output monitoring in very preterm infants to predict in-hospital neonatal outcomes: a bicentric retrospective cohort study |
| title_sort | early urine output monitoring in very preterm infants to predict in hospital neonatal outcomes a bicentric retrospective cohort study |
| url | https://bmjopen.bmj.com/content/13/1/e068300.full |
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