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Fluid and electrolyte management in the very low birth weight neonate

Journal of Perinatology volume 26, pages S19–S21 (2006)Cite this article

Abstract

Fluid and electrolyte management in the very low birth weight infant is critical to survival. The amount of fluid present in the plasma, interstitial fluid, and cellular fluid changes throughout the fetal and neonatal period, presenting a challenging situation. One of the many factors influencing fluid requirements is the insensible water loss by mechanisms such as evaporation. Low birth weight infants are especially susceptible to this due to their large body surface area and immature skin, often resulting in hypernatremia and the complications associated with it. However, some infants may experience hyperkalemia, hyperglycemia, and/or hyponatremia, resulting in various other complications. Careful monitoring is essential in deciding how to manage these infants. This article aims to discuss the management of fluid and electrolytes in very low birth weight infants and address ways to decrease the morbidity and mortality associated with the imbalances in fluid and electrolytes seen in this population.

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References

  1. Friis-Hansen B . Body water compartments in children: changes during growth and related changes in body composition. Pediatrics 1961; 28: 169–181.

    CAS  PubMed  Google Scholar 

  2. Harding R . Fetal lung fluid. In: Brace RA, Ross MG, Robillard JE (eds). Fetal and Neonatal Body Fluids: The Scientific Basis for Clinical Practice. Perinatology Press: New York, 1989, pp 41–64.

    Google Scholar 

  3. Maloney JE . Preparation of the respiratory system for the early neonatal period. J Dev Physiol 1984; 6: 21–30.

    CAS  PubMed  Google Scholar 

  4. Kitterman JA, Ballard PL, Clements JA, Mescher EJ, Tooley WH . Tracheal fluid in fetal lambs: spontaneous decrease prior to birth. J Appl Physiol 1979; 47: 985–989.

    Article  CAS  Google Scholar 

  5. Bland RD, McMillan DD, Bressack MA, Dong L . Clearance of liquid from lungs of newborn rabbits. J Appl Physiol 1980; 49: 171–177.

    Article  CAS  Google Scholar 

  6. Perks AM, Cassin S . The effects of arginine vasopressin and other factors on the production of lung fluid in fetal goats. Chest 1982; 81S: 63S–65S.

    Article  Google Scholar 

  7. Comline RS, Silver M . The composition of foetal and maternal blood during parturition in the ewe. J Physiol 1972; 222: 233–256.

    Article  CAS  Google Scholar 

  8. Linderkamp O . Placental transfusion: determinants and effects. Clin Perinatol 1982; 9: 559–592.

    Article  CAS  Google Scholar 

  9. Oh W, Blankenship W, Lind J . Further study of neonatal blood volume in relation to placental transfusion. Ann Pediatr 1966; 207: 147–159.

    Google Scholar 

  10. Loren JM, Kleinman LI, Ahmed G, Markarian K . Phases of fluid and electrolyte homeostasis in the extremely low birth weight infant. Pediatrics 1995; 96: 484–489.

    Google Scholar 

  11. Schaffer SG, Meade V . Sodium balance and extracellular volume regulation in very low birth weight infants. J Pediatr 1989; 115: 285–290.

    Article  Google Scholar 

  12. Hartnoll G, Betremieux P, Modi N . Randomised controlled trial of postnatal sodium supplementation on oxygen dependency and body weight in 25–30 week gestational age infants. Arch Dis Child Fetal Neonatal Ed 2000; 82: F19–F23.

    Article  CAS  Google Scholar 

  13. Costarino AT, Gruskay JA, Corcoran L, Polin RA, Baumgart S . Sodium restriction versus daily maintenance replacement in very low birth weight neonates: a randomized, blind therapeutic trial. J Pediatr 1992; 120: 99–106.

    Article  Google Scholar 

  14. Rutter N, Hull D . Water loss from the skin of term and preterm babies. Arch Dis Child 1979; 54: 858–868.

    Article  CAS  Google Scholar 

  15. Costarino AT, Baumgart S . Modern fluid and electrolyte management of the critically ill premature infant. Ped Clin North Am 1986; 33: 153–178.

    Article  CAS  Google Scholar 

  16. Parish A, Bhatia J . Nutritional considerations in the intensive care unit: neonatal issues. In: Shikora SA, Martindale RG, Schwaitzberg SD (eds). Nutritional Considerations in the Intensive Care Unit – Science, Rationale and Practice. Kendall/Hunt: Iowa, 2002, pp 297–309.

    Google Scholar 

  17. Baumgart S, Langman CB, Sosulski R, Fox WW, Polin RA . Fluid, electrolyte, and glucose maintenance in the very low birth weight infant. Clin Pediatr 1982; 21: 199–206.

    Article  CAS  Google Scholar 

  18. Baumgart S, Costarino AT . Water and electrolyte metabolism of the micropremie. Clin Perinatol 2000; 27: 131–146.

    Article  CAS  Google Scholar 

  19. Bartley JH, Nagy S, Frank M, Bhatia J . Inadvertent sodium load in the first 5 days of life in extremely low birth weight infants. J Perinatol 2004; 24: 593.

    Google Scholar 

  20. Bell EF, Warburton D, Stonestreet BS, Oh W . Effect of fluid administration on the development of symptomatic patent ductus arteriosus and congestive heart failure in premature infants. N Eng J Med 1980; 302: 598–604.

    Article  CAS  Google Scholar 

  21. Van Marter LJ, Pagano M, Allred EN, Leviton A, Kuban KC . Rate of bronchopulmonary dysplasia as a function of neonatal intensive care practices. J Pediatr 1992; 120: 938–946.

    Article  CAS  Google Scholar 

  22. Spahr RC, Klein AM, Brown DR, Holzman IR, MacDonald HM . Fluid administration and bronchopulmonary dysplasia. Am J Dis Child 1980; 134: 958–960.

    Article  CAS  Google Scholar 

  23. Davis ID, Avner ED . Fluid and electrolyte management. In: Fanaraff AA, Martin RJ (eds). Neonatal-Perinatal Medicine: Diseases of the Fetus and Infant, 7th edn, Mosby: Missouri, 2002, pp 619–627.

    Google Scholar 

Download references

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  1. Department of Pediatrics, Medical College of Georgia, Augusta, GA, USA

    J Bhatia

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Bhatia, J. Fluid and electrolyte management in the very low birth weight neonate. J Perinatol 26 (Suppl 1), S19–S21 (2006). https://doi.org/10.1038/sj.jp.7211466

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