ELBW infants receive inadvertent sodium load above the recommended intake.
Pediatr Res
; 88(3): 412-420, 2020 09.
Article
in En
| MEDLINE
| ID: mdl-32272484
ABSTRACT
BACKGROUND:
To determine total sodium load, including inadvertent load, during the first 2 postnatal weeks, and its influence on serum sodium, morbidity, and mortality in extremely low birth weight (ELBW, birth weight <1000 g) infants and to calculate sodium replacement models.METHODS:
Retrospective data analysis on ELBW infants with a gestational age <28 + 0/7 weeks.RESULTS:
Ninety patients with a median birth weight of 718 g and a median gestational age of 24 + 6/7 weeks were included. Median sodium intake during the first 2 postnatal weeks was 10.2 mmol/kg/day, which was significantly higher than recommended (2-5 mmol/kg/day). Sodium intake did not affect the risk for hypernatremia. Each mmol of sodium intake during the first postnatal week was associated with an increased risk of bronchopulmonary dysplasia (45%) and higher-grade intraventricular hemorrhage (31%), during the second postnatal week for necrotizing enterocolitis (19%), and during both postnatal weeks of mortality (13%). Calculations of two sodium replacement models resulted in a decrease in sodium intake during the first postnatal week of 3.2 and 4.0 mmol/kg/day, respectively.CONCLUSIONS:
Sodium load during the first 2 postnatal weeks of ELBW infants was significantly higher than recommended owing to inadvertent sodium intake and was associated with a higher risk of subsequent morbidity and mortality, although the study design does not allow conclusions on causality. Replacement of 0.9% saline with alternative carrier solutions might reduce sodium intake. IMPACT Sodium intake in ELBW infants during the first 2 postnatal weeks was twofold to threefold higher than recommended; this was mainly caused by inadvertent sodium components. High sodium intake is not related to severe hypernatremia but might be associated with a higher morbidity in terms of BPD, IVH, and NEC. Inadvertent sodium load can be reduced by replacing high sodium-containing carrier solutions with high levels of sodium with alternative hypotonic and/or balanced fluids, model based.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Birth Weight
/
Sodium, Dietary
Type of study:
Observational_studies
Limits:
Female
/
Humans
/
Male
/
Newborn
Language:
En
Journal:
Pediatr Res
Year:
2020
Type:
Article
Affiliation country:
Austria