The Indian Journal of Pediatrics

, Volume 68, Issue 12, pp 1139–1142

Fluid and electrolyte management in term and preterm neonates

  • Rajiv Aggarwal
  • Ashok K. Deorari
  • Vinod K. Paul
AIIMS Protocols in Neonatology-II
  • 199 Downloads

Abstract

Disorders of fluid and electrolyte are common in neonates. Proper understanding of the physiological changes in body water and solute after birth is essential to ensure a smooth transition from the aquaticin utero environment. The newborn kidney has a limited capacity to excrete excess water and sodium and overload of fluid or sodium in the first week may result in conditions like necrotizing enterocolitis and patent ductus arteriosus. The beneficial effect of fluid restriction on the neonatal morbidity has been shown in multiple clinical trials. Simple measures like use of transparent plastic barriers, caps and socks are effective in reducing insensible water loss. Guidelines for the management of fluids according to birth weight, day of life and specific clinical conditions are provided in the protocols.

Key words

Fluid disorders Kidneys Sodium 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Bell EF, Oh W. Fluid and electrolyte management. In Avery GB, Fletcher MA, MacDonald MG, eds.Neonatology: Pathophysiology of the Newborn. 5th edn. Lippincott Williams and Wilkins, Philadelphia 1999; 345–361.Google Scholar
  2. 2.
    Modi N. Renal function, fluid and electrolyte balance and neonatal renal disease. In Rennie JM, Roberton NRC, eds.Textbook of Neonatology. 3rd edn. Churchill Livingstone, Edinburgh 1999; 1009–1036.Google Scholar
  3. 3.
    Hartnoll G, Betremieux P, Modi N. Randomized controlled trial of postnatal sodium supplementation in infants of 25–30 weeks gestational age: effects on cardiopulmonary adaptation.Arch Dis Child Fetal Neonatal Ed 2001; 85: 29–32.CrossRefGoogle Scholar
  4. 4.
    Hartnoll G, Betremieux P, Modi N. Randomized controlled trial of postnatal sodium supplementation on oxygen dependency and body weight in 25–30 week gestational age infants.Arch Dis Child Fetal Neonatal Ed 2000; 82: 19–23.CrossRefGoogle Scholar
  5. 5.
    Randomized controlled trial of postnatal sodium supplementation on body composition in 25–30 week gestational age infants.Arch Dis Child Fetal Neonatal Ed 2000; 82 : 24–28.Google Scholar
  6. 6.
    Al-Dahhan J, Haycock GB, Nichol B, Chantier C, Stimmler L. Sodium hemostasis in term and preterm neonates: III. Effect of salt supplementation.Arch Dis Child 1984; 59: 945–950.PubMedCrossRefGoogle Scholar
  7. 7.
    Haycock GB. The influence of sodium on growth in infancy.Pediatr Nephrol 1993; 7: 871–875.PubMedCrossRefGoogle Scholar
  8. 8.
    Herin P, Zetterstrom R. Sodium, potassium and chloride needs in low birth weight infants.Acta Pediatr Suppl 1994; 405: 43–48.Google Scholar
  9. 9.
    Mbiti MJ, Ayisi RK, Orinda. DA. Sodium supplementation in very low birth weight infants fed on their own mother’s milk: II. Effects on protein and bone metabolism.East Afr Med J 1992; 69: 627–630.PubMedGoogle Scholar
  10. 10.
    Ayisi RK, Mbiti MJ, Musoke RN, Orinda DA. Sodium supplementation in very low birth weight infants fed on their own mother’s milk: I. Effects on sodium hemostasis.East Afr Med J 1992; 69: 591–595.PubMedGoogle Scholar
  11. 11.
    Higgins ST, Baumgart S. Fluid and electrolyte disorders. In Spitzer AR, ed.Intensive Care of the Fetus and Neonate. Mosby-Year Book, St. Louis 1996; 1034–1049.Google Scholar
  12. 12.
    Bell EF, Acarregui MJ. Restricted versus liberal water intake for preventing morbidity and mortality in preterm infants.Cochrane Database Syst Rev 2000; (2) : CD000503.Google Scholar

Copyright information

© Dr. K C Chaudhuri Foundation 2001

Authors and Affiliations

  • Rajiv Aggarwal
    • 1
  • Ashok K. Deorari
    • 1
  • Vinod K. Paul
    • 1
  1. 1.Division of Neonatology, Department of PediatricsAll India Institute of Medical SciencesNew DelhiIndia
  2. 2.Department of PediatricsAll India Institute of Medical SciencesNew Delhi

Personalised recommendations