Abstract
Standard fluid therapy recommendations may contribute to the occurrence of significant patent ductus arteriosus (PDA) and bronchopulmonary dysplasia (BPD) in RDS. Fluids given to 83 infants with RDS were limited in volume to meet only estimated insensible fluid loss; infants 1501-2400gm (N=59) received 25 cc/kg/da and infants 800-1500gm received 45 cc/kg/da (N=24). Additional fluids were administered if radiant warmer and/or phototherapy were used. 16/24 (66%) and 18/59 (30%) required mechanical ventilation. Adequate urine output was demonstrated in infants >1500gm by a mean volume ratio of fluid input/urine output (I:0) of 1.06 (0.65-1.50); for infants <1500gm I:0 equaled 1.17 (0.8-1.6). Infants in both groups had normal urine specific gravity; mean 1.012 (1.002-1.018). All 83 infants maintained normal hematocrit and serum Na, K, Cl, and glucose. All infants lost weight during the first 48 hours: mean body weight loss was 5% (0.8-8.8%). PDA was diagnosed on the basis of heart murmur, bounding pulses, and echographic LA/Ao ratio ≥1.2:1; incidence was 7.2% (6/83). BPD was diagnosed by radiographic findings and persistence of increased A-aDO2 and CO2 retention; incidence was 2.4% (2/83). Six infants died (mean birth wt 1010gm): intracranial hemorrhage 3, meningitis 1, digoxin toxicity 1, airleak syndrome 1.
Conclusions: 1) infants with RDS can maintain fluid homeostasis despite restriction; 2) fluids limited to meeting only insensible losses may minimize the occurrence of PDA and BPD.
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Desai, N., Pauly, T., Johnson, G. et al. 1174 RESTRICTED FLUID THERAPY IN THE RESPIRATORY-DISTRESS SYNDROME (RDS). Pediatr Res 12 (Suppl 4), 559 (1978). https://doi.org/10.1203/00006450-197804001-01180
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DOI: https://doi.org/10.1203/00006450-197804001-01180