Chloride Balance in Preterm Infants during the First Week of Life

Iacobelli, Simona; Kermorvant‐Duchemin, Elsa; Bonsante, Francesco; Lapillonne, Alexandre; Gouyon, Jean‐Bernard

doi:10.1155/2012/931597

Cited by 17 publications

(16 citation statements)

References 25 publications

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“…Iacobelli et al (13,33) have shown that amino acid intake, energy intake, and extremely low gestational age are all factors influencing potassium balance. The potassium balance is positive (94% of cases) when daily amino acid intake is >2 g Á kg À1 Á day À1 and negative (92%) when amino acid intake is low (<1.5 g Á kg À1 Á day À1 ).…”

Section: Impact Of New Guidelines On Potassium Balancementioning

confidence: 99%

Biological Impact of Recent Guidelines on Parenteral Nutrition in Preterm Infants

Guellec

Gascoin

Beuchée

et al. 2015

J. pediatr. gastroenterol. nutr.

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Section: Impact Of New Guidelines On Potassium Balancementioning

confidence: 99%

Biological Impact of Recent Guidelines on Parenteral Nutrition in Preterm Infants

Guellec

Gascoin

Beuchée

et al. 2015

J. pediatr. gastroenterol. nutr.

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“…Interesting also, in Group 2 and 3 the rise of nutrient intakes promotes acidosis despite the optimization of sodium and chloride inputs performed in our unit. Indeed, the augmentation of differential Na + /Cl - intake observed in groups 2 and 3 should play a protective role against acidosis [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

“…Sodium and chloride inputs were also recorded, and the differential Na + –Cl - mean intake was calculated as this is known to influence metabolic acid-basic abnormalities [ 17 , 18 ].…”

Section: Methodsmentioning

confidence: 99%

Early optimal parenteral nutrition and metabolic acidosis in very preterm infants

et al. 2017

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BackgroundIt is currently recognized that an optimized nutritional approach, consisting of an early and substantial supply of protein and energy by parenteral route, may be beneficial for very low birth weight infants and recent guidelines endorse this strategy. However, the impact of enhanced parenteral nutrition (PN) on acid-basic balance has never been investigated. The aim of the present study is to assess the effect of nutrient intake on acid-base homeostasis in a large population of preterm infants on PN.MethodsThis observational study described the acid-base profile of very preterm infants (≤29 week’s gestation) receiving PN during the first week of life. For this purpose three different cohorts of infants who received increasing (group 1 to group 3) nutritional intakes were considered. Nutrition data were recorded daily and correlated to acid-base data (pH, base excess, and lactate). The outcome measure to assess metabolic acidosis was the base excess (BE).Results161 infants were included. 1127 daily nutritional records and 795 blood gas data were analyzed. The three groups were different with regard to nutritional intravenous intakes. Group 3 in particular had a higher mean intake of both amino acids (3.3 ± 0.8 g/kg/d) and lipids (2.8 ± 1.4 g/kg/d) during the first week of life. Metabolic acidosis was more severe in the group with the highest parenteral intake of amino acids and lipids: mean BE = -8.7 ± 3.4 (group 3); -6.4 ± 3.4 (group 2); -5.1 ± 3.0 (group 1)]. At the multivariate analysis the significant risk factors for metabolic acidosis were: gestational age, initial base excess, amino acid and lipid intravenous intakes.DiscussionAcid-base homeostasis was influenced by the nutritional intake. Earlier and higher intravenous amino acid and lipid intakes particularly increased the risk of metabolic acidosis. The nutritional tolerance was different depending on gestational age, and the smaller infants (24–26 week’s gestation) displayed greater acidotic disequilibrium and a higher need of bicarbonate.

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“…Reference intervals for chloride are not well defined in preterm infants. We used the ±2 SD intervals from Iacobelli et al ( 16 ), providing a range of 100 to 120 mmol/L during the first week of life.…”

Section: Methodsmentioning

confidence: 99%

Higher Parenteral Electrolyte Intakes in Preterm Infants During First Week of Life: Effects on Electrolyte Imbalances

Späth

Sjöström

Domellöf

2022

Journal of Pediatric Gastroenterology &Amp; Nutrition

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Objectives: This study aimed to investigate the effects of a higher intake of electrolytes from parenteral nutrition (PN) on plasma electrolyte concentrations in very low birth weight (VLBW, <1500 g) infants. Methods: This was a single-center cohort study including all VLBW infants born before (n = 81) and after (n = 53) the implementation of a concentrated PN regimen. Daily nutritional intakes and plasma concentrations of sodium, chloride, potassium, phosphate, and calcium were collected from clinical charts. Results: During the first postnatal week, electrolyte intakes were higher in infants who received concentrated PN compared with infants who received original PN. Infants who received concentrated PN had a lower incidence of hypokalemia (<3.5 mmol/L; 30% vs 76%, P < 0.001) and severe hypophosphatemia (<1.0 mmol/L; 2.2% vs 17%, P = 0.02). While the relatively high prevalence of severe hypophosphatemia in infants who received original PN can be explained by a phosphorus intake below the recommendation, the potassium intake during the first 3 postnatal days (mean ± SD: 0.7 ± 0.2 mmol/kg/d) was within the recommendation. The prevalence of early hypernatremia was not affected by the different sodium intake in the 2 groups. Conclusions: In VLBW infants, a sodium-containing PN solution (about 2.7 mmol/100 mL) does not cause hypernatremia during the first days of life. Furthermore, providing at least 1 mmol potassium/kg/d during the first 3 postnatal days might be necessary to prevent early hypokalemia.

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Chloride Balance in Preterm Infants during the First Week of Life

Cited by 17 publications

References 25 publications

Biological Impact of Recent Guidelines on Parenteral Nutrition in Preterm Infants

Biological Impact of Recent Guidelines on Parenteral Nutrition in Preterm Infants

Early optimal parenteral nutrition and metabolic acidosis in very preterm infants

Higher Parenteral Electrolyte Intakes in Preterm Infants During First Week of Life: Effects on Electrolyte Imbalances

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