Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Improved Fluid Management Utilizing Humidified Incubators in Extremely Low Birth Weight Infants

Journal of Perinatology volume 21, pages 438–443 (2001)Cite this article

Abstract

OBJECTIVE: To compare fluid and electrolyte management in extremely low birth weight (ELBW) infants nursed in humidified versus nonhumidified incubators.

STUDY DESIGN: Setting — tertiary intensive care nursery. Subjects — all infants with birth weight <1000 g admitted 1/95 to 1/99 who were treated with incubators and survived for >96 hours (N=155). Intervention — retrospective comparison of daily weights, fluid intakes, urine outputs, and serum electrolytes between group 1 (n=70, nonhumidified incubators, born 1/95 to 1/97) and group 2 (n=85, humidified incubators, born 1/97 to 1/99) over the first 4 days after birth.

RESULTS: Despite similar daily weight losses between groups, group 1 infants received higher fluid intakes, had lower urine outputs, and had a higher incidence of hypernatremia, hyperkalemia, and azotemia (p<0.05). Although no differences in mortality or the incidence of patent ductus arteriosus, bronchopulmonary dysplasia, or the overall rate of nosocomial infections were observed, the proportion of gram-negative isolates increased significantly (62%, p<0.05) following the introduction of humidified incubators.

CONCLUSIONS: ELBW weight infants nursed in humidified incubators have lower fluid requirements, improved electrolyte balance, and higher urine outputs during the first 4 days after birth compared to those nursed in nonhumidified incubators.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

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

    Article  CAS  Google Scholar 

  2. Costarino A, Baumgart S Modern fluid and electrolyte management of the critically ill premature infant Pediatr Clin North Am 1986 33 153–78

    Article  CAS  Google Scholar 

  3. Lorenz JM, Kleinman LI, Kotagal UR, Reller MD Water balance in very low-birth-weight infants: relationship to water and sodium intake and effect on outcome J Pediatr 1982 101 423–32

    Article  CAS  Google Scholar 

  4. Lorenz JM, Kleinman LI, Ahmed G, Markarinn K Phases of fluid and electrolyte homeostasis in the extremely low birthweight infant Pediatrics 1995 96 484–9

    CAS  PubMed  Google Scholar 

  5. Harpin VA, Rutter N Barrier properties of the newborn infant's skin J Pediatr 1983 102 419–25

    Article  CAS  Google Scholar 

  6. Baumgart S Radiant energy and insensible water loss in the premature newborn infant nursed under a radiant warmer Clin Perinatol 1982 9 483–503

    Article  CAS  Google Scholar 

  7. Pildes RS, Pyati SP Hypoglycemia and hyperglycemia in tiny infants Clin Perinatol 1986 13 351–75

    Article  CAS  Google Scholar 

  8. Gruskay J, Costarino AT, Polin RA, Baumgart S Nonoliguric hyperkalemia in the premature infant weighing less than 1000 grams J Pediatr 1988 113 381–6

    Article  CAS  Google Scholar 

  9. Oh W, Karecki H Phototherapy and insensible water loss in the newborn infant Am J Dis Child 1972 124 230–2

    CAS  PubMed  Google Scholar 

  10. Bell EF, Gray JC, Weinstein MR, Oh W The effects of thermal environment on heat balance and insensible water loss in low-birth-weight infants J Pediatr 1980 96 452–9

    Article  CAS  Google Scholar 

  11. 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 Engl J Med 1980 302 598–604

    Article  CAS  Google Scholar 

  12. Marshall DD, Kotelchuck M, Young TE, Bose CL, Kruyer L, O'Shea TM Risk factors for chronic lung disease in the surfactant era: a North Carolina population-based study of very low birthweight infants Pediatrics 1999 104 1345–50

    Article  CAS  Google Scholar 

  13. Baumgart S, Engle WD, Fox WW, Polin RA Effect of heat shielding on convective and evaporative heat losses and on radiant heat transfer in the premature infant J Pediatr 1981 99 948–56

    Article  CAS  Google Scholar 

  14. Baumgart S Reduction of oxygen consumption, insensible water loss, and radiant heat demand with use of a plastic blanket for low-birth-weight infants under radiant warmers Pediatrics 1984 74 1022–8

    CAS  PubMed  Google Scholar 

  15. Nopper AJ, Horii KA, Sookdeo-Drost S, Wang TH, Mancini AJ, Lane AT Topical ointment therapy benefits premature infants J Pediatr 1996 128 660–9

    Article  CAS  Google Scholar 

  16. Gaylord MS, Lorch S, Lorch V, Wright P The novel use of sterile water gastric drips for management of fluid and electrolyte abnormalities in extremely low birthweight infants Neonat Intensive Care 1995 May/June 44–64

  17. Silverman WA, Blanc WA The effect of humidity on survival of newly born premature infants Pediatrics 1957 20 477–87

    CAS  PubMed  Google Scholar 

  18. Sauer PJ, Dane HJ, Visser HK Influence of variations in the ambient humidity on insensible water loss and thermoneutral environment of low birthweight infants Acta Paediatr Scand 1984 73 615–9

    Article  CAS  Google Scholar 

  19. Garnan JS, Jarvis WR, Emon TG, Horan TC, Hughes JM CDC definitions for nosocomial infections In: Olmstead RN, editor. APIC Infection Control and Applied Epidemiology: Principles and Practice St. Louis: Mosby 1996 p. A-1–A-20

  20. Hack M, Horbar JD, Malloy MH, Tyson JE, Wright E, Wright L Very low birthweight outcomes of the National Institute of Child Health and Human Development Neonatal Network Pediatrics 1991 87 587–97

    CAS  PubMed  Google Scholar 

  21. Rutter N The immature skin Br Med Bull 1988 44 957–70

    Article  CAS  Google Scholar 

  22. Hammarlund K, Sedin G Transepidermal water loss in newborn infants: III. Relation to gestational age Acta Paediatr Scand 1979 68 795–801

    Article  CAS  Google Scholar 

  23. Bell EF, Rios GR A double-walled incubator alters the partition of body heat loss of premature infants Pediatr Res 1983 17 135–40

    Article  CAS  Google Scholar 

  24. Porat R, Brodsky N Effect of Tegaderm use on outcome of extremely low birthweight infants Pediatr Res 1993 33 231 (A)

    Google Scholar 

  25. Harpin VA, Rutter N Humidification of incubators Arch Dis Child 1985 60 219–24

    Article  CAS  Google Scholar 

  26. Moffet HL, Allan D, Williams T Survival and dissemination of bacteria in nebulizers and incubators Am J Dis Child 1967 114 13–20

    CAS  PubMed  Google Scholar 

  27. Johnson A, Ross M, Cavallaro C, Strauch D Humidification of Incubators. A continuing education module Ohmeda Medical Inc 1997

    Google Scholar 

  28. Belgaumkar TK, Scott KE Effects of low humidity on small premature infants in servocontrol incubators Biol Neonate 1975 26 348–52

    Article  CAS  Google Scholar 

  29. Hey EN, Maurice NP Effect of humidity on production and loss of heat in the newborn baby Arch Dis Child 1968 43 166–71

    Article  CAS  Google Scholar 

  30. Locke R, Leef K, McGreevey T, Stefano J Nonthermoregulatory effects of supplemental incubator humidity in premature infants Pediatr Res 2000 47 413 (A)

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. University of Tennessee Graduate School of Medicine, Knoxville, TN, USA

    Mark S Gaylord MD, Kelly Wright MD & Vichien Lorch MD

  2. Emory University, Atlanta, GA, USA

    Kimberly Lorch

  3. Department of Statistics, University of Tennessee, Knoxville, TN, USA

    Esteban Walker PhD

Authors
  1. Mark S Gaylord MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kelly Wright MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kimberly Lorch
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Vichien Lorch MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Esteban Walker PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Gaylord, M., Wright, K., Lorch, K. et al. Improved Fluid Management Utilizing Humidified Incubators in Extremely Low Birth Weight Infants. J Perinatol 21, 438–443 (2001). https://doi.org/10.1038/sj.jp.7210561

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.jp.7210561

Search

Advanced search

Quick links