{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T21:39:34Z","timestamp":1776721174128,"version":"3.51.2"},"reference-count":38,"publisher":"Necmettin Erbakan University Press","issue":"03","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Pediatr Intensive Care"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The aim of the study is to examine the relationship between fluid overload (FO) and severity of respiratory dysfunction in children posthematopoietic cell transplantation (HCT) with pediatric acute respiratory distress syndrome (PARDS). This investigation was a secondary analysis of a multicenter retrospective cohort of children (1month to 21 years) postallogeneic HCT with PARDS receiving invasive mechanical ventilation (IMV) from 2009 to 2014. Daily FO % (FO%) and daily oxygenation index (OI) were calculated for each patient up to the first week of IMV (day 0\u2009=\u2009intubation). Linear mixed-effect regression was employed to examine whether FO% and OI were associated on any day during the study period. In total, 158 patients were included. Severe PARDS represented 63% of the cohort and had higher mortality (78 vs. 42%, p &lt;0.001), fewer ventilator free days at 28 (0 [IQR: 0\u20130] vs. 14 [IQR: 0\u201323], p &lt;0.001), and 60 days (0 [IQR: 0\u201327] v. 45 [IQR: 0\u201355], p &lt;0.001) relative to nonsevere PARDS. Increasing FO% was strongly associated with higher OI (p &lt;0.001). For children with 10% FO, OI was higher by nearly 5 points (adjusted \u03b2, 4.6, 95% CI: [2.9, 6.3]). In subgroup analyses, the association between FO% and OI was strongest among severe PARDS (p &lt;0.001) and during the first 3 days elapsed from intubation (p &lt;0.001). FO% was associated with lower PaO2\/FiO2 (adjusted \u03b2, \u22121.92, 95% CI: [\u22123.11, \u22120.73], p\u2009=\u20090.002), but not mean airway pressure (p\u2009=\u20090.746). In a multicenter cohort of children post-HCT with PARDS, FO was independently associated with oxygenation impairment. The associations were strongest among children with severe PARDS and early in the course of IMV.<\/jats:p>","DOI":"10.1055\/s-0042-1757480","type":"journal-article","created":{"date-parts":[[2022,10,11]],"date-time":"2022-10-11T19:03:53Z","timestamp":1665515033000},"page":"286-295","source":"Crossref","is-referenced-by-count":3,"title":["Fluid Overload in Pediatric Acute Respiratory Distress Syndrome after Allogeneic Hematopoietic Cell Transplantation"],"prefix":"10.53391","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2834-2657","authenticated-orcid":false,"given":"Colin J.","family":"Sallee","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Critical Care, UCLA Mattel Children's Hospital, University of California Los Angeles, Los Angeles, California, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julie C.","family":"Fitzgerald","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care, Division of Critical Care, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lincoln S.","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Critical Care Medicine, Seattle Children's Hospital, University of Washington, Seattle, Washington, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph R.","family":"Angelo","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Renal Section, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Megan C.","family":"Daniel","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Critical Care, Nationwide Children's Hospital, The Ohio State University, Columbus, Ohio, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shira J.","family":"Gertz","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Critical Care, Saint Barnabas Medical Center, Livingston, New Jersey, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deyin D.","family":"Hsing","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Critical Care, Weil Cornell Medical College, New York Presbyterian Hospital, New York City, New York, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kris M.","family":"Mahadeo","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Pediatric Stem Cell Transplantation and Cellular Therapy, Children's Cancer Hospital, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer A.","family":"McArthur","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Critical Care, St Jude Children's Research Hospital, Memphis, Tennessee, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Courtney M.","family":"Rowan","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Critical Care, Riley Hospital for Children, Indiana University School of Medicine, Indianapolis, Indiana, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"on behalf of the Pediatric Acute Lung Injury Sepsis Investigators (PALISI) Network","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"31409","published-online":{"date-parts":[[2022,10,11]]},"reference":[{"issue":"08","key":"ref1","doi-asserted-by":"crossref","first-page":"1342","DOI":"10.1016\/j.bbmt.2017.04.018","article-title":"Hematopoietic stem cell transplantation activity in pediatric cancer between 2008 and 2014 in the United States: a center for international blood and marrow transplant research report","volume":"23","author":"P Khandelwal","year":"2017","journal-title":"Biol Blood Marrow Transplant"},{"issue":"09","key":"ref2","doi-asserted-by":"crossref","first-page":"1986","DOI":"10.1097\/CCM.0000000000001085","article-title":"New insights into multicenter PICU mortality among pediatric hematopoietic stem cell transplant patients","volume":"43","author":"M S Zinter","year":"2015","journal-title":"Crit Care Med"},{"issue":"02","key":"ref3","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1016\/j.bbmt.2019.09.027","article-title":"Comprehensive prognostication in critically ill pediatric hematopoietic cell transplant patients: results from merging the center for international blood and marrow transplant research (CIBMTR) and virtual pediatric systems (VPS) registries","volume":"26","author":"M S Zinter","year":"2020","journal-title":"Biol Blood Marrow Transplant"},{"issue":"04","key":"ref4","doi-asserted-by":"crossref","first-page":"294","DOI":"10.1097\/PCC.0000000000000673","article-title":"Invasive mechanical ventilation and mortality in pediatric hematopoietic stem cell transplantation: a multicenter study","volume":"17","author":"C M Rowan","year":"2016","journal-title":"Pediatr Crit Care Med"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"755878","DOI":"10.3389\/fonc.2021.755878","article-title":"Pulmonary complications after pediatric stem cell transplant","volume":"11","author":"T Fitch","year":"2021","journal-title":"Front Oncol"},{"issue":"04","key":"ref6","doi-asserted-by":"crossref","first-page":"304","DOI":"10.1097\/PCC.0000000000001061","article-title":"Pediatric acute respiratory distress syndrome in pediatric allogeneic hematopoietic stem cell transplants: a multicenter study","volume":"18","author":"C M Rowan","year":"2017","journal-title":"Pediatr Crit Care Med"},{"issue":"02","key":"ref7","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1016\/S2213-2600(18)30344-8","article-title":"Paediatric acute respiratory distress syndrome incidence and epidemiology (PARDIE): an international, observational study","volume":"7","author":"R G Khemani","year":"2019","journal-title":"Lancet Respir Med"},{"issue":"03","key":"ref8","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1001\/jamapediatrics.2017.4540","article-title":"Association between fluid balance and outcomes in critically ill children: a systematic review and meta-analysis","volume":"172","author":"R Alobaidi","year":"2018","journal-title":"JAMA Pediatr"},{"issue":"01","key":"ref9","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1007\/s00467-003-1313-z","article-title":"Fluid overload and acute renal failure in pediatric stem cell transplant patients","volume":"19","author":"M Michael","year":"2004","journal-title":"Pediatr Nephrol"},{"issue":"05","key":"ref10","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1007\/s002770050288","article-title":"Risk factors for capillary leakage syndrome after bone marrow transplantation","volume":"74","author":"W N\u00fcrnberger","year":"1997","journal-title":"Ann Hematol"},{"issue":"06","key":"ref11","doi-asserted-by":"crossref","first-page":"1150","DOI":"10.1038\/sj.leu.2402946","article-title":"Proinflammatory cytokines and their role in the development of major transplant-related complications in the early phase after allogeneic bone marrow transplantation","volume":"17","author":"R Schots","year":"2003","journal-title":"Leukemia"},{"issue":"10","key":"ref12","doi-asserted-by":"crossref","first-page":"2326","DOI":"10.1038\/s41409-021-01390-y","article-title":"Endothelial cell dysfunction: a key determinant for the outcome of allogeneic stem cell transplantation","volume":"56","author":"T Luft","year":"2021","journal-title":"Bone Marrow Transplant"},{"issue":"10","key":"ref13","doi-asserted-by":"crossref","first-page":"2883","DOI":"10.1097\/CCM.0b013e31825bc54d","article-title":"Fluid balance in critically ill children with acute lung injury","volume":"40","author":"S L Valentine","year":"2012","journal-title":"Crit Care Med"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1186\/s40560-020-00496-7","article-title":"Fluid management in ARDS: an evaluation of current practice and the association between early diuretic use and hospital mortality","volume":"8","author":"K P Seitz","year":"2020","journal-title":"J Intensive Care"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"705602","DOI":"10.3389\/fonc.2021.705602","article-title":"Early cumulative fluid balance and outcomes in pediatric allogeneic hematopoietic cell transplant recipients with acute respiratory failure: a multicenter study","volume":"11","author":"C J Sallee","year":"2021","journal-title":"Front Oncol"},{"issue":"18","key":"ref16","doi-asserted-by":"crossref","first-page":"1334","DOI":"10.1056\/NEJM200005043421806","article-title":"The acute respiratory distress syndrome","volume":"342","author":"L B Ware","year":"2000","journal-title":"N Engl J Med"},{"issue":"02","key":"ref17","doi-asserted-by":"crossref","first-page":"472","DOI":"10.1097\/CCM.0b013e31826ab377","article-title":"Extravascular lung water is an independent prognostic factor in patients with acute respiratory distress syndrome","volume":"41","author":"M Jozwiak","year":"2013","journal-title":"Crit Care Med"},{"issue":"01","key":"ref18","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1186\/s13613-015-0081-9","article-title":"Extravascular lung water in critical care: recent advances and clinical applications","volume":"5","author":"M Jozwiak","year":"2015","journal-title":"Ann Intensive Care"},{"issue":"24","key":"ref19","doi-asserted-by":"crossref","first-page":"2564","DOI":"10.1056\/NEJMoa062200","article-title":"Comparison of two fluid-management strategies in acute lung injury","volume":"354","author":"H P Wiedemann","year":"2006","journal-title":"N Engl J Med"},{"key":"ref20","doi-asserted-by":"crossref","first-page":"S23","DOI":"10.1097\/PCC.0000000000000432","article-title":"Pediatric acute respiratory distress syndrome: definition, incidence, and epidemiology: proceedings from the Pediatric Acute Lung Injury Consensus Conference","volume":"16","author":"R G Khemani","year":"2015","journal-title":"Pediatr Crit Care Med"},{"issue":"06","key":"ref21","doi-asserted-by":"crossref","first-page":"1309","DOI":"10.1542\/peds.107.6.1309","article-title":"Outcome in children receiving continuous venovenous hemofiltration","volume":"107","author":"S L Goldstein","year":"2001","journal-title":"Pediatrics"},{"issue":"05","key":"ref22","doi-asserted-by":"crossref","first-page":"428","DOI":"10.1097\/PCC.0000000000000350","article-title":"Pediatric acute respiratory distress syndrome: consensus recommendations from the Pediatric Acute Lung Injury Consensus Conference","volume":"16","author":"P ALICC Group","year":"2015","journal-title":"Pediatr Crit Care Med"},{"issue":"10","key":"ref23","doi-asserted-by":"crossref","first-page":"e967","DOI":"10.1097\/CCM.0000000000003277","article-title":"Acute respiratory failure in pediatric hematopoietic cell transplantation: a multicenter study","volume":"46","author":"C M Rowan","year":"2018","journal-title":"Crit Care Med"},{"issue":"03","key":"ref24","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1097\/PCC.0b013e31822882a3","article-title":"Fluid overload is associated with impaired oxygenation and morbidity in critically ill children","volume":"13","author":"A A Arikan","year":"2012","journal-title":"Pediatr Crit Care Med"},{"issue":"01","key":"ref25","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1186\/s13613-018-0402-x","article-title":"Principles of fluid management and stewardship in septic shock: it is time to consider the four D's and the four phases of fluid therapy","volume":"8","author":"M LNG Malbrain","year":"2018","journal-title":"Ann Intensive Care"},{"issue":"04","key":"ref26","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1186\/cc6948","article-title":"Fluid balance as a biomarker: impact of fluid overload on outcome in critically ill patients with acute kidney injury","volume":"12","author":"S M Bagshaw","year":"2008","journal-title":"Crit Care"},{"issue":"02","key":"ref27","doi-asserted-by":"crossref","first-page":"316","DOI":"10.1053\/j.ajkd.2009.10.048","article-title":"Fluid overload and mortality in children receiving continuous renal replacement therapy: the prospective pediatric continuous renal replacement therapy registry","volume":"55","author":"S M Sutherland","year":"2010","journal-title":"Am J Kidney Dis"},{"issue":"03","key":"ref28","doi-asserted-by":"crossref","first-page":"240","DOI":"10.1056\/NEJMoa2000741","article-title":"Timing of initiation of renal-replacement therapy in acute kidney injury","volume":"383","author":"S M Bagshaw","year":"2020","journal-title":"N Engl J Med"},{"issue":"01","key":"ref29","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1177\/0885066612457343","article-title":"Outcome of pediatric hematopoietic stem cell transplant recipients requiring mechanical ventilation","volume":"29","author":"F Aspesberro","year":"2014","journal-title":"J Intensive Care Med"},{"issue":"03","key":"ref30","doi-asserted-by":"crossref","first-page":"540","DOI":"10.1002\/pbc.22561","article-title":"Impact of continuous renal replacement therapy on oxygenation in children with acute lung injury after allogeneic hematopoietic stem cell transplantation","volume":"55","author":"L Elbahlawan","year":"2010","journal-title":"Pediatr Blood Cancer"},{"issue":"09","key":"ref31","doi-asserted-by":"crossref","first-page":"795","DOI":"10.1097\/PCC.0000000000002765","article-title":"Timing and clinical significance of fluid overload in pediatric acute respiratory distress syndrome","volume":"22","author":"C G Black","year":"2021","journal-title":"Pediatr Crit Care Med"},{"issue":"03","key":"ref32","doi-asserted-by":"crossref","first-page":"L224","DOI":"10.1152\/ajplung.00336.2015","article-title":"Plasma angiopoietin-2 outperforms other markers of endothelial injury in prognosticating pediatric ARDS mortality","volume":"310","author":"M S Zinter","year":"2016","journal-title":"Am J Physiol Lung Cell Mol Physiol"},{"issue":"06","key":"ref33","doi-asserted-by":"crossref","first-page":"1731","DOI":"10.1097\/CCM.0b013e3182451c87","article-title":"Plasma angiopoietin-2 in clinical acute lung injury: prognostic and pathogenetic significance","volume":"40","author":"C S Calfee","year":"2012","journal-title":"Crit Care Med"},{"issue":"06","key":"ref34","doi-asserted-by":"crossref","first-page":"1376","DOI":"10.1164\/ajrccm.163.6.2004035","article-title":"Alveolar fluid clearance is impaired in the majority of patients with acute lung injury and the acute respiratory distress syndrome","volume":"163","author":"L B Ware","year":"2001","journal-title":"Am J Respir Crit Care Med"},{"issue":"02","key":"ref35","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1172\/JCI110049","article-title":"Treatment of acute low pressure pulmonary edema in dogs: relative effects of hydrostatic and oncotic pressure, nitroprusside, and positive end-expiratory pressure","volume":"67","author":"R M Prewitt","year":"1981","journal-title":"J Clin Invest"},{"issue":"04","key":"ref36","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1172\/JCI6872","article-title":"Pressure is proinflammatory in lung venular capillaries","volume":"104","author":"W M Kuebler","year":"1999","journal-title":"J Clin Invest"},{"issue":"06","key":"ref37","doi-asserted-by":"crossref","first-page":"e514","DOI":"10.1097\/CCM.0000000000004345","article-title":"Predicting mortality in children with pediatric acute respiratory distress syndrome: a pediatric acute respiratory distress syndrome incidence and epidemiology study","volume":"48","author":"N Yehya","year":"2020","journal-title":"Crit Care Med"},{"issue":"10","key":"ref38","doi-asserted-by":"crossref","first-page":"907","DOI":"10.1097\/PCC.0000000000000865","article-title":"A simple and robust bedside model for mortality risk in pediatric patients with acute respiratory distress syndrome","volume":"17","author":"A C Spicer","year":"2016","journal-title":"Pediatr Crit Care Med"}],"container-title":["Journal of Pediatric Intensive Care"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0042-1757480.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,17]],"date-time":"2025-09-17T19:50:29Z","timestamp":1758138629000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0042-1757480"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,10,11]]},"references-count":38,"journal-issue":{"issue":"03","published-online":{"date-parts":[[2024,9,6]]},"published-print":{"date-parts":[[2024,9]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0042-1757480","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["2146-4618","2146-4626"],"issn-type":[{"value":"2146-4618","type":"print"},{"value":"2146-4626","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,10,11]]}}}