Abstract
The clinical effects of fluid inputs designed to maintain different degrees of negative water balance during the first 5 days of life were determined prospectively in 68 LBW infants. AGA infants with birth weights of 750-1500 g were matched for birth weight (BW) in 250 g increments, RDS or no RDS, asphyxiated or not, and inborn or outborn. Each infant was randomized to either Group I -- fluids managed to allow 1-2% loss of BW per day to a maximum loss of 8-10%, or Group II -- fluids managed to allow 3-5% loss of BW per day to a maximum loss of 13-15%. The mean 5 day cumulative fluid input in Group II was 230 ml/kg less than in Group I, yet Group II lost only 45 g/kg more than did Group I (8% of BW lost in Group I vs 12.5% of BW lost in Group II, p<0.01). There were no statistically significant differences (p>0.20) in incidence of clinically significant PDA, intracranial hemorrhage, BPD, NEC, hypernatremia, excesive weight loss (>20% BW), mortality, time on O2 or ventilator, or time to discharge. Group II had a higher incidence of hypoglycemia (serum glu<40mg%) than Group I (12/34 vs 1/34, p<0.001). Hypoglycemia occured only in infants receiving less than 5mg/kg/min glucose for at least 2 days. We conclude that fluid input in LBW infants can be flexible to allow 1-5% loss of BW per day to a maximum loss of 8-15% during the first five days of life, as long as more than 5mg/kg/min of glucose is provided.
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Lorenz, J., Kleinman, L. & Kotagal, U. 1361 EFFECT OF WATER BALANCE ON CLINICAL OUTCOME IN LOW BIRTH WEIGHT (LBW) INFANTS. Pediatr Res 15 (Suppl 4), 670 (1981). https://doi.org/10.1203/00006450-198104001-01390
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DOI: https://doi.org/10.1203/00006450-198104001-01390