Abstract
Rapid blood volume expansion in VLBW infants has been suggested as a cause of ICH. We calculated, prospectively, hourly fluctuation in the rate (ml/kg/day) of fluid actually revived in 10 acutely ill, VLBW (B.Wt. & Gest. Age: 1.07±0.07 kg and 30±0.7 wks), during the first 72 hours. Volume actually received were noted hourly, without nurses' knowledge. Fluctuations from ordered rate were calculated for 614 hours. Mean IV fluid ordered and actually received did not differ, however, wide hourly fluctuations in the rate occurred in all infants. Table gives % of time fluctuation in rate of fluid actually received (expressed as ml/kg/day) occurring in the study infants. During 614 hours only 4% of time infants got ordered amount at ordered rate. 25% of time hourly fluctuations were >50 ml/kg/day. Excess and deficit rates were equal, thus total volume received was equal to ordered amount. Rapid rates >80 ml/kg occurred more often in ICH infants (Stat.N.S.). Fluctuations were due to voltage variation (10%), transfusion (10%), infiltrations of IV and the ‘adjustments’ nurses make to make up ordered volume at the end of 8 hour shift. We conclude: a) Both fluid volume and rate actually received by the infant should be checked hourly in VLBW infants; b) These fluctuations may be responsible for hypo or hyperglycemia, appearance and disappearance of PDA murmurs and possibly ICH in VLBW infants.
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Raju, T., Chow-Tung, E. 623 FLUCTUATIONS IN THE RATE OF IV FLUID ADMINISTRATION TO VERY LOW BIRTH WEIGHT (VLBW) INFANTS. Pediatr Res 15 (Suppl 4), 544 (1981). https://doi.org/10.1203/00006450-198104001-00636
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DOI: https://doi.org/10.1203/00006450-198104001-00636