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The Impact of Restricted versus Liberal Early Fluid Volumes on Plasma Sodium, Weight Change, and Short-Term Outcomes in Extremely Preterm Infants

The optimal fluid requirements for extremely preterm infants are not fully known. We examined retrospectively the fluid intakes during the first week of life in two cohorts of extremely preterm infants born at 22–26 weeks of gestation before (n = 63) and after a change from a restrictive to a more l...

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Autores principales: Diderholm, Barbro, Normann, Erik, Ahlsson, Fredrik, Sindelar, Richard, Ågren, Johan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8878438/
https://www.ncbi.nlm.nih.gov/pubmed/35215444
http://dx.doi.org/10.3390/nu14040795
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author Diderholm, Barbro
Normann, Erik
Ahlsson, Fredrik
Sindelar, Richard
Ågren, Johan
author_facet Diderholm, Barbro
Normann, Erik
Ahlsson, Fredrik
Sindelar, Richard
Ågren, Johan
author_sort Diderholm, Barbro
collection PubMed
description The optimal fluid requirements for extremely preterm infants are not fully known. We examined retrospectively the fluid intakes during the first week of life in two cohorts of extremely preterm infants born at 22–26 weeks of gestation before (n = 63) and after a change from a restrictive to a more liberal (n = 112) fluid volume allowance to improve nutrient provision. The cohorts were similar in gestational age and birth weight, but antenatal steroid exposure was more frequent in the second era. Although fluid management resulted in a cumulative difference in the total fluid intake over the first week of 87 mL/kg (p < 0.001), this was not reflected in a mean weight loss (14 ± 5% at a postnatal age of 4 days in both groups) or mean peak plasma sodium (142 ± 5 and 143 ± 5 mmol/L in the restrictive and liberal groups, respectively). The incidences of hypernatremia (>145 and >150 mmol/L), PDA ligation, bronchopulmonary dysplasia, and IVH were also similar. We conclude that in this cohort of extremely preterm infants a more liberal vs. a restricted fluid allowance during the first week had no clinically important influence on early changes in body weight, sodium homeostasis, or hospital morbidities.
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spelling pubmed-88784382022-02-26 The Impact of Restricted versus Liberal Early Fluid Volumes on Plasma Sodium, Weight Change, and Short-Term Outcomes in Extremely Preterm Infants Diderholm, Barbro Normann, Erik Ahlsson, Fredrik Sindelar, Richard Ågren, Johan Nutrients Article The optimal fluid requirements for extremely preterm infants are not fully known. We examined retrospectively the fluid intakes during the first week of life in two cohorts of extremely preterm infants born at 22–26 weeks of gestation before (n = 63) and after a change from a restrictive to a more liberal (n = 112) fluid volume allowance to improve nutrient provision. The cohorts were similar in gestational age and birth weight, but antenatal steroid exposure was more frequent in the second era. Although fluid management resulted in a cumulative difference in the total fluid intake over the first week of 87 mL/kg (p < 0.001), this was not reflected in a mean weight loss (14 ± 5% at a postnatal age of 4 days in both groups) or mean peak plasma sodium (142 ± 5 and 143 ± 5 mmol/L in the restrictive and liberal groups, respectively). The incidences of hypernatremia (>145 and >150 mmol/L), PDA ligation, bronchopulmonary dysplasia, and IVH were also similar. We conclude that in this cohort of extremely preterm infants a more liberal vs. a restricted fluid allowance during the first week had no clinically important influence on early changes in body weight, sodium homeostasis, or hospital morbidities. MDPI 2022-02-14 /pmc/articles/PMC8878438/ /pubmed/35215444 http://dx.doi.org/10.3390/nu14040795 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Diderholm, Barbro
Normann, Erik
Ahlsson, Fredrik
Sindelar, Richard
Ågren, Johan
The Impact of Restricted versus Liberal Early Fluid Volumes on Plasma Sodium, Weight Change, and Short-Term Outcomes in Extremely Preterm Infants
title The Impact of Restricted versus Liberal Early Fluid Volumes on Plasma Sodium, Weight Change, and Short-Term Outcomes in Extremely Preterm Infants
title_full The Impact of Restricted versus Liberal Early Fluid Volumes on Plasma Sodium, Weight Change, and Short-Term Outcomes in Extremely Preterm Infants
title_fullStr The Impact of Restricted versus Liberal Early Fluid Volumes on Plasma Sodium, Weight Change, and Short-Term Outcomes in Extremely Preterm Infants
title_full_unstemmed The Impact of Restricted versus Liberal Early Fluid Volumes on Plasma Sodium, Weight Change, and Short-Term Outcomes in Extremely Preterm Infants
title_short The Impact of Restricted versus Liberal Early Fluid Volumes on Plasma Sodium, Weight Change, and Short-Term Outcomes in Extremely Preterm Infants
title_sort impact of restricted versus liberal early fluid volumes on plasma sodium, weight change, and short-term outcomes in extremely preterm infants
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8878438/
https://www.ncbi.nlm.nih.gov/pubmed/35215444
http://dx.doi.org/10.3390/nu14040795
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