Fluid overload among critically ill children with acute kidney injury: A tertiary care experience of Western Odisha

Introduction: Acute Kidney Injury (AKI) is a frequent clinical complication in paediatric critically ill patients who often develop Fluid Overload (FO). Objectives: To study the occurrence of FO among critically ill patients admitted to Pediatric Intensive Care Unit (PICU) with AKI and study its association with age, sex, stages of AKI and duration of hospitalization. Materials and Method: A cross-sectional study was conducted in the PICU of a tertiary care hospital of Western Odisha enrolling 140 patients by simple consecutive sampling with inclusion criteria being critically ill children admitted for 24 hrs or more in PICU in the age group of one completed month to 14 completed years having AKI as per pRIFLE criteria; and patients with pre-existing renal diseases, less than 1-month age were excluded. FO percentage was calculated using equation [{Total fluid in (in ltrs) – Total fluid out (in ltrs)}/Admission body weight (in kgs) X 100]. A score of 10% or more was considered to be indicative of fluid overload (FO ≥10%). All the cases were followed up till discharge and / or death & the relevant data including demographic characters like age, sex, body weight at admission and stages of AKI were collected and analysed in SPSSv24. Results: The association between age group and FO≥10% is significant. The occurrence of FO ≥10% in male children (75.3%) is significantly higher than that in case of females (58.8%). There is no significant difference in mean duration of hospitalisation in days between three stages of AKI (Risk, Injury and Failure). Conclusion: Duration of hospitalisation in PICU does not alter with the various stages of AKI may it be Risk or Injury or Failure. It's the fluid overload in the pre-ICU setting before getting admitted to PICU predicts the outcome.