Accepted for Publication: July 5, 2011.
Published Online: July 22, 2011. doi:10.1001/archpediatrics.2011.152
Author Contributions: Study concept and design: Hickey, Beattie, Cowieson, Beck, and Tarr. Acquisition of data: Hickey, Beattie, Cowieson, Miyashita, Strife, Frem, Peterson, Butani, Jones, Havens, Patel, Wong, Andreoli, Beck, and Tarr. Analysis and interpretation of data: Hickey, Wong, Rothbaum, and Beck. Drafting of the manuscript: Hickey, Wong, Rothbaum, and Tarr. Critical revision of the manuscript for important intellectual content: Hickey, Beattie, Cowieson, Miyashita, Strife, Frem, Peterson, Butani, Jones, Havens, Patel, Wong, Andreoli, Rothbaum, Beck, and Tarr. Statistical analysis: Hickey, Rothbaum, and Tarr. Obtained funding: Hickey and Tarr. Administrative, technical, and material support: Hickey, Beattie, Cowieson, Miyashita, Strife, Peterson, Butani, Jones, and Tarr. Study supervision: Beattie, Cowieson, Frem, Havens, Wong, Andreoli, Rothbaum, Beck, and Tarr.
Financial Disclosure: None reported.
Funding/Support: This study was supported by the Doris Duke Clinical Research Fellowship in the design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, and approval of the manuscript.
Additional Contributions: We thank Michael DeBaun, MD, PhD, for guidance, encouragement, and insight; Marguerite Neill for helpful comments on the manuscript; Joyce Linn, Elizabeth Wolf, and William Bennett, MD, from Washington University School of Medicine, St Louis, Missouri, for administrative and technical assistance; Jingnan Mao, MS, for statistical advice; Melissa Christensen from Medical College of Wisconsin, Milwaukee, and Children's Hospital of Wisconsin, Natalie Zipper from Indiana University School of Medicine, Indianapolis, and Riley Hospital for Children for extracting data; Christine Musser and Alison Griffith for manuscript assistance; the patients' families for providing us with the data needed to perform this study; and house and nursing staff at the participating institutions for their roles in gathering and recording data for this study in the course of their clinical involvement with the patients.
Editor's Note: There have been more than 3000 cases of enterohemorrhagic Escherichia coli infections and more than 900 cases of hemolytic uremic syndrome reported in 16 countries in Europe and North America since the E coli outbreak began in Germany on May 1, 2011. This multicenter study provides strong evidence that intravenous volume expansion during the first 4 days of diarrhea due to E coli O157:H7 infection may protect from oligoanuria in children who subsequently develop hemolytic uremic syndrome. Because of the important public health implications of this study, we have decided to publish this article quickly online ahead of print.