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Randomized Controlled Trial
. 2012 Jan;160(1):38-43.e1.
doi: 10.1016/j.jpeds.2011.06.027. Epub 2011 Aug 11.

Randomized controlled trial of restrictive fluid management in transient tachypnea of the newborn

Annemarie Stroustrup  1 , Leonardo Trasande, Ian R Holzman
Affiliations
Randomized Controlled Trial

Randomized controlled trial of restrictive fluid management in transient tachypnea of the newborn

Annemarie Stroustrup et al. J Pediatr. 2012 Jan.

Abstract

Objective: To determine the effect of mild fluid restriction on the hospital course of neonates with transient tachypnea of the newborn (TTN).

Study design: In this pilot prospective randomized controlled trial of 64 late preterm and term neonates diagnosed with TTN at a single tertiary care hospital in the United States, patients were randomized to receive standard fluid management or mild fluid restriction. The primary outcome was duration of respiratory support. Secondary outcomes were duration of admission to the intensive care unit, time to first enteral feed, and total and composite hospital costs. Results were analyzed by t-test, χ(2) test, Kaplan-Meier estimation, and proportional hazards regression.

Results: Fluid restriction did not cause adverse events or unsafe dehydration. Fluid management strategy did not affect primary or secondary outcomes in the total study population. Fluid restriction significantly reduced the duration of respiratory support (P = .008) and hospitalization costs (P = .017) in neonates with severe TTN.

Conclusion: Mild fluid restriction appears to be safe in late preterm and term neonates with uncomplicated TTN. Fluid restriction may be of benefit in decreasing the duration of respiratory support and reducing hospitalization costs in term and late preterm neonates with uncomplicated severe TTN.

Trial registration: ClinicalTrials.gov NCT01225029.

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Figures

Figure 1
Figure 1
Patient enrollment. All patients approached for study enrollment and eventual severity classification of disease are depicted.
Figure 2
Figure 2
Survival analysis of the effect of fluid management on duration of respiratory support. Solid lines represent standard fluid management while dash lines represents restrictive fluid management. A) In the overall study cohort there was no statistically significant effect of fluid management strategy on duration of respiratory support. In patients with severe TTN an unadjusted model (B) and a model adjusted for gestational age and receipt of antenatal steroids (C) demonstrate significant decreased duration of respiratory support for neonates receiving restricted total fluids.
Figure 2
Figure 2
Survival analysis of the effect of fluid management on duration of respiratory support. Solid lines represent standard fluid management while dash lines represents restrictive fluid management. A) In the overall study cohort there was no statistically significant effect of fluid management strategy on duration of respiratory support. In patients with severe TTN an unadjusted model (B) and a model adjusted for gestational age and receipt of antenatal steroids (C) demonstrate significant decreased duration of respiratory support for neonates receiving restricted total fluids.
Figure 2
Figure 2
Survival analysis of the effect of fluid management on duration of respiratory support. Solid lines represent standard fluid management while dash lines represents restrictive fluid management. A) In the overall study cohort there was no statistically significant effect of fluid management strategy on duration of respiratory support. In patients with severe TTN an unadjusted model (B) and a model adjusted for gestational age and receipt of antenatal steroids (C) demonstrate significant decreased duration of respiratory support for neonates receiving restricted total fluids.
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References

    1. Helve O, Janer C, Pitkanen O, Andersson S. Expression of the epithelial sodium channel in airway epithelium of newborn infants depends on gestational age. Pediatrics. 2007;120:1311–6. - PubMed
    1. Jain L, Eaton DC. Physiology of fetal lung fluid clearance and the effect of labor. Semin Perinatol. 2006;30:34–43. - PubMed
    1. Jain L, Dudell GG. Respiratory transition in infants delivered by cesarean section. Semin Perinatol. 2006;30:296–304. - PubMed
    1. Martin JA, Hamilton BE, Sutton PD, Ventura SJ, Mathews TJ, Kirmeyer S, et al. Births: final data for 2007. Natl Vital Stat Rep. 2010;58:1–85. - PubMed
    1. Martin JA, Kirmeyer S, Osterman M, Shepherd RA. Born a bit too early: recent trends in late preterm births. NCHS Data Brief. 2009;1:8. - PubMed

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