Abstract
Infusion of isotonic solutions in newborns is recommended to avoid potential complications of osmolar toxicity such as intra-ventricular and pulmonary hemorrhage. Addition of colloids to infusates promotes prolonged vascular retention of fluids before dissipation into the extravascular spaces. Proper isotonic and iso-oncotic formulation of solutions for newborns was determined by a) analysis of albumin and oncotic pressure (OP) in 147 cord blood (CB) specimens by HBABA dye method and a WescorR oncometer, respectively and b) analysis of the osmolality, by freezing point depression, and the OP of various formulated solutions. Combinations of 4,5,6 and 7 gm/dl of albumin plus ¼,½,1 and 2 mEq NaHCO3/10 ml of solution were formulated with: sterile water (SW), D5W, D10W, .25 normal saline (NS), .5 NS, NS, lactated ringers (LR) and 1/6M Na lactate.
Results: CB albumin: 2.6-4.3 gm/dl, x 3.2 ± .05 (SEM); CB OP: 16.2 - 24.2 mmHg, x 19.7 ± .33 (SEM). 5 gm/dl albumin results in mean CB OP. Addition of 4-7 gm/dl albumin to a solution does not significantly increase its osmolality. NaHCO3 has no effect on a solution's OP. All solutions became hypertonic with 2 mEq NaHCO3/10 ml. Initially hypotonic solutions, i.e., SW, .25 NS, .5 NS and LR, can be formulated with NaHCO3 to achieve an isotonic solution.
Conclusion: Isotonic solutions with varying anion composition can be rapidly and easily formulated. Albumin can be added to an isotonic solution without significantly increasing its osmolality.
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Golden, S., Steenbarger, J., Monaghan, W. et al. 1309 OSMOLALITY, ONCOTIC PRESSURE AND FLUID ADMINISTRATION IN THE NEWBORN. Pediatr Res 15 (Suppl 4), 661 (1981). https://doi.org/10.1203/00006450-198104001-01338
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DOI: https://doi.org/10.1203/00006450-198104001-01338