Publications by authors named "Heidi J Steflik"
Objective: Compare neonatal intensive care unit hospitalization costs between neonates with and without AKI; identify predictors of AKI-associated costs. We hypothesized neonates with AKI would amass more costs than those without AKI.
Study Design: Retrospective, multicenter cohort study of surviving neonates cared for 2015-2021 in Pediatric Health Information System database.
Importance: Kidney disease is common in infants admitted to the neonatal intensive care unit (NICU). Despite the risk of chronic kidney disease (CKD) in infants discharged from the NICU, neither evidence- nor expert-based recommendations exist to guide clinical care after discharge.
Objective: To develop recommendations for risk stratification and kidney health monitoring among infants after discharge from the NICU.
Article Synopsis
- * The study explores the link between post-natal steroids (PNS) and acute kidney injury (AKI) in very low birthweight (VLBW) infants, testing the hypothesis that PNS might lower AKI risk. * Researchers conducted a review of 567 VLBW neonates, finding that 17.1% were exposed to PNS, and 22.9% experienced AKI, with PNS exposure correlated with lower health indicators in infants. * The results suggest that PNS increases the risk of AKI in VLBW infants, contradicting the hypothesis, and highlight the need for further research into adrenal insufficiency (AI) and its impact on kidney health.
Article Synopsis
- - The study highlights significant disparities in health outcomes for Black preterm (BPT) infants compared to White preterm (WPT) infants, including a 65% higher birthrate of BPT infants and a nearly 2.3 times higher mortality rate due to infections.
- - Researchers analyzed data from 367 preterm infants born before 32 weeks gestation to investigate the onset of infections, focusing specifically on thermal gradients and heart rates; BPT infants accounted for a substantial majority of infection cases, particularly late-onset sepsis.
- - Findings indicated that BPT infants had a higher likelihood of both early-onset and late-onset sepsis compared to WPT infants, with a notable prevalence of Gram-positive and
Background: We evaluated time-varying perinatal risk factors associated with early (≤7 post-natal days) and late (>7 post-natal days) severe acute kidney injury (AKI) occurrence and duration.
Methods: A secondary analysis of Preterm Erythropoietin Neuroprotection Trial data. We defined severe AKI (stage 2 or 3) per neonatal modified Kidney Disease: Improving Global Outcomes criteria.
Introduction: The incidence of thrombocytopenia in neonates receiving extracorporeal membrane oxygenation (ECMO) with and without concurrent continuous renal replacement therapy (CRRT) and associated complications have not been well described. The primary aims of the current study were to (1) characterize thrombocytopenia in neonates receiving ECMO (including those treated concurrently with CRRT) and (2) evaluate risk factors (including CRRT utilization) associated with severe thrombocytopenia. In a planned exploratory secondary aim, we explored the association of severe thrombocytopenia with outcomes in neonates receiving ECMO.
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- The study examines the incidence and outcomes of recurrent acute kidney injury (rAKI) in critically ill neonates, highlighting a gap in current knowledge.
- Conducted as a secondary analysis of a larger international study, the research focused on neonates under 14 days old who received intravenous fluids and excluded those with severe congenital issues.
- Findings revealed that 22% of neonates with acute kidney injury developed rAKI, associated with younger gestational ages, lower birthweights, and more severe initial AKI; these infants had longer hospital stays compared to those without AKI.
Article Synopsis
- The study aimed to identify the incidence, risk factors, and outcomes of recurrent neonatal acute kidney injury (rAKI) in a NICU cohort.
- Among 869 neonates, 19% experienced acute kidney injury (AKI), with 12% having a single episode (sAKI) and 7% experiencing recurrent AKI (rAKI).
- sAKI was linked to significantly higher mortality rates, while both types of AKI were associated with longer mechanical ventilation and hospital stays, highlighting the need for further research on rAKI's clinical implications.
Objective: The objective of this study is to examine patent ductus arteriosus (PDA) response by treatment course and investigate associations with postmenstrual age (PMA), chronological age (CA), gestational age (GA), antenatal steroid exposure (ANS), birthweight (BW), weight at treatment initiation (WT), and PDA/left pulmonary artery (LPA) ratio.
Study Design: This is a single-center retrospective cohort study of preterm infants less than 37 weeks' GA born January 1, 2016 to December 31, 2018 who received acetaminophen and/or indomethacin for PDA treatment. Cox proportional hazards regression models were used to determine whether factors of interest were associated with PDA response to medical treatment.
Background: We aimed to describe nephrotoxic medication exposure and investigate associations between exposure and acute kidney injury (AKI) in the neonatal intensive care unit during the first postnatal week.
Design/methods: Secondary analysis of the AWAKEN cohort. We evaluated nephrotoxic medication exposure during the first postnatal week and associations with AKI using time-varying Cox proportional hazard regressions models.
Article Synopsis
- The study compared hospitalization costs for critically-ill neonates with patent ductus arteriosus (PDA) who developed acute kidney injury (AKI) versus those who did not.
- Data from 49 hospitals showed that neonates with AKI had significantly longer hospital stays (median of 71 days) and higher total hospital costs ($190,063) compared to those without AKI (28 days and $141,647, respectively).
- AKI was found to be an independent factor that increased costs by about $48,416, highlighting the financial impact of this condition in critically-ill neonates with PDA.
Background: Acute kidney injury (AKI) and fluid overload (FO) are associated with poor outcomes in children receiving extracorporeal membrane oxygenation (ECMO). Our objective is to evaluate the impact of AKI and FO on pediatric patients receiving ECMO for cardiac pathology.
Methods: We performed a secondary analysis of the six-center Kidney Interventions During Extracorporeal Membrane Oxygenation (KIDMO) database, including only children who underwent ECMO for cardiac pathology.
Acute kidney injury (AKI) is a common occurrence in the neonatal intensive care unit (NICU). In recent years, our knowledge of the incidence and impact of neonatal AKI on outcomes has expanded exponentially. Neonatal AKI has been shown to be associated with adverse outcomes including increased length of mechanical ventilation, prolonged length of stay, and rise in mortality.
View Article and Find Full Text PDFThis guideline for extracorporeal membrane oxygenation (ECMO) fluid and electrolyte management for all patient populations is intended for educational use to build the knowledge of physicians and other health professionals in assessing the conditions and managing the treatment of patients undergoing extracorporeal life support (ECLS)/ECMO and describe what are believed to be useful and safe practice for ECLS/ECMO, but these are not necessarily consensus recommendations. The aim of clinical guidelines is to help clinicians to make informed decisions about their patients. However, adherence to a guideline does not guarantee a successful outcome.
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