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\begin{document}

\title{Intravenous Fluid Therapy and Hospital Outcomes for Vaso-Occlusive
Episodes in Children, Adolescents, and Young Adults with Sickle Cell
Disease}



\author[1]{Abraham Haimed}%
\author[2]{Rebecca Weiss}%
\author[2]{Soyang Kwon}%
\author[1]{Rukhmi Bhat}%
\author[1]{Sherif Badawy}%
\affil[1]{Divison of Hematology Oncology and Stem Cell Transplantation Ann and Robert H Lurie Children’s Hospital of Chicago}%
\affil[2]{Northwestern University Feinberg School of Medicine}%


\vspace{-1em}



  
  \date{June 10, 2024}


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\begin{abstract}
\textbf{Background:} While intravenous fluid (IVF) therapy in patients
with sickle cell disease (SCD) admitted for a vaso-occlusive episodes
(VOE) can help reduce red blood cell sickling, clinical practice varies
across institutions. We examined the relationship between IVF therapy
and hospital length of stay (HLOS), as well as adverse events, such as
acute chest syndrome (ACS), pediatric intensive care unit (PICU)
transfer and 28-day readmission. \textbf{Methods:} This is a
single-center retrospective analysis of SCD VOE hospitalizations between
January 2015 and April 2020. Patients with SCD, age 0-30, with
consecutive hospitalizations for VOE were included. For the first 3 days
of each admission, an ``IVF ratio'' was calculated by dividing actual
IVF rate administered by weight-based maintenance IVF (mIVF) rate.
\textbf{Results:} A total of 617 hospitalizations for 161 patients were
included. Mean HLOS was 5.7 days, (SD 3.9), and mean IVF volume over the
first 3 days of admission was 139.6 ml/kg/day (SD 57.8). Multivariate
analysis showed that for each additional 0.5 times the mIVF rate, HLOS
increased by 0.53 days (P\textless{}0.001; 95\% CI: 0.609--0.989), but
there was no significant association between IVF therapy and adverse
events. History of chronic pain was associated with increased odds of
readmission (OR, 6.4; 95\% CI: 3.93 -- 10.52). \textbf{Conclusions:}
Despite the theoretical potential for IVF therapy to slow down the
sickling process, our findings suggest that increased IVF therapy was
associated with prolonged HLOS, which places a burden on patients,
families, and the health system.%
\end{abstract}%



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\textbf{Hosted file}

\verb`Haimed_Manuscript_Final.docx`  available at \url{https://authorea.com/users/628910/articles/649359-intravenous-fluid-therapy-and-hospital-outcomes-for-vaso-occlusive-episodes-in-children-adolescents-and-young-adults-with-sickle-cell-disease}

\textbf{Hosted file}

\verb`Haimed_Manuscript Figure.docx`  available at \url{https://authorea.com/users/628910/articles/649359-intravenous-fluid-therapy-and-hospital-outcomes-for-vaso-occlusive-episodes-in-children-adolescents-and-young-adults-with-sickle-cell-disease}

\textbf{Hosted file}

\verb`Haimed_Manuscript Tables.docx`  available at \url{https://authorea.com/users/628910/articles/649359-intravenous-fluid-therapy-and-hospital-outcomes-for-vaso-occlusive-episodes-in-children-adolescents-and-young-adults-with-sickle-cell-disease}

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\end{document}

