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Fluid, Electrolyte and Nutritional Support of the Surgical Neonate

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Rickham's Neonatal Surgery

Abstract

The newborn infant is in a “critical epoch” of development. A healthy term infant grows at a rate of 25–30 g per day over the first 6 months of life, so that weight has doubled by the age of 5 months. This growth clearly requires adequate nutrition, but especially where medical or surgical conditions exist, must also be carefully managed together with fluid and electrolytes. Thus a significant period of inadequate nutrition, or inappropriate fluid and electrolyte administration, may not only affect short-term outcomes, but may also be a risk factor for the long-term menace of stunted mental and physical development. Amongst preterm infants, lower in-hospital growth velocity is associated with impaired neurodevelopmental outcome. Fluids and electrolytes undergo changes during the perinatal period, so an understanding of the perinatal changes in body composition is useful to understand the principles behind the fluid, electrolyte and nutritional management of surgical neonates. As well as providing the components necessary for increase in tissue mass, adequate provision of nutrients is also required to mount an appropriate immune response is extremely important, as infection and sepsis may impair growth and neurodevelopmental outcome.

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Authors and Affiliations

  1. Department of Paediatric Surgery, UCL Institute of Child Health and Great Ormond Street Children’s Hospital, London, UK

    Paolo De Coppi MD, PhD

  2. Surgery Unit, Institute of Child Health, London, UK

    Agostino Pierro MD, FRCS(Eng), OBE

  3. Division of General and Thoracic Surgery, The Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, M5G 1X8 Ontario, Canada

    Simon Eaton PhD

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  1. Simon Eaton PhD
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  2. Paolo De Coppi MD, PhD
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  3. Agostino Pierro MD, FRCS(Eng), OBE
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Correspondence to Agostino Pierro MD, FRCS(Eng), OBE .

Editor information

Editors and Affiliations

  1. Division of Child Health, Alder Hey Children’s NHS Foundation Trust, Liverpool, United Kingdom

    Paul D. Losty

  2. University of Pennsylvania , Philadelphia, Pennsylvania, USA

    Alan W. Flake

  3. Childrens Hospital, University of Helsinki, Helsinki, Finland

    Risto J. Rintala

  4. Royal Children’s Hospital, University of Melbourne, Parkville, Victoria, Australia

    John M. Hutson

  5. Department of Surgery, Meiji University of Integrative Medicine, Kyoto, Japan

    Naomi lwai

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Eaton, S., De Coppi, P., Pierro, A. (2018). Fluid, Electrolyte and Nutritional Support of the Surgical Neonate. In: Losty, P., Flake, A., Rintala, R., Hutson, J., lwai, N. (eds) Rickham's Neonatal Surgery. Springer, London. https://doi.org/10.1007/978-1-4471-4721-3_8

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