Advertisement

Fluid and electrolyte management in term and preterm neonates

  • Deepak Chawla
  • Ramesh Agarwal
  • Ashok K. DeorariEmail author
  • Vinod K. Paul
Symposium on AIIMS Protocols in Neonatology-III

Abstract

Disorders of fluid and electrolyte are common in neonates and a proper understanding of the physiological changes in body water and solute after birth is essential to ensure a smooth transition from the aquatic in-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 morbidities like necrotizing enterocolitis, patent ductus arteriosus and chronic lung disease. Simple measures like use of transparent plastic barriers, coconut oil application, 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 protocol.

Key words

Fluid requirement Electrolyte Neonates Insensible water loss 

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 ed; Philadelphia, Lippincott Williams and Wilkins, 1999: 345–361.Google Scholar
  2. 2.
    Modi N. Renal function, fluid and electrolyte balance and neonatal renal disease. In Rennie JM, Roberton NRC Churchill, eds. Textbook of Neonatology, 3rd ed. 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 2001; 85: F29–F32.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 2000; 82: F19–F23.CrossRefGoogle Scholar
  5. 5.
    Hartnoll G, Bétré mieuxp, Modi N. Randomized controlled trial of postnatal sodium supplementation on body composition in 25–30 week gestational age infants. Arch Dis Child Fetal Neonatal 2000; 82: F24–F28.CrossRefGoogle Scholar
  6. 6.
    Al-Dahhan J, Haycock GB, Nichol B, Chantler 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.CrossRefGoogle 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.
    Nangia S, Paul V K, Chawla D, Agarwal R, Deorari AK, Sreenivas V. Topical coconut oil application reduces transepidermal water loss (TEWL) in very low birth weight (VLBW) neonates: A randomized clinical trial. E-PAS 2007; 61: 7933.21Google Scholar
  13. 13.
    Kaushal M, Agarwal R, Aggarwal R, Singal A, Upadhyay M, Srinivas V, Paul VK, Deorari AK. Cling wrap, an innovative intervention for temperature maintenance and reduction of insensible water loss in very low-birthweight babies nursed under radiant warmers: a randomized, controlled trial. Ann Trop Paediatr 2005; 25: 111–118.PubMedCrossRefGoogle Scholar
  14. 14.
    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 2008

Authors and Affiliations

  • Deepak Chawla
    • 1
  • Ramesh Agarwal
    • 1
  • Ashok K. Deorari
    • 1
    Email author
  • Vinod K. Paul
    • 1
  1. 1.Division of Neonatology, Department of PediatricsAll India Institute of Medical SciencesAnsari Nagar, New DelhiIndia

Personalised recommendations