Positive fluid balance and diuretic therapy are associated with mechanical ventilation and mortality in preterm neonates in the first fourteen postnatal days

Wright, Mariah L; Klamer, Brett; Bonachea, Elizabeth; Spencer, John David; Slaughter, Jonathan L.; Mohamed, Tahagod

doi:10.1007/s00467-022-05861-2

Cited by 1 publication

(1 citation statement)

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“…Fluid requirements will depend upon those factors described above that impact IWL, in particular gestational age and housing environment. Recent publications demonstrate that postnatal weight losses of 5–12% of birthweight and a return to birth weight no sooner than 10 days after birth are associated with decreased risk of morbidity in extremely preterm infants, including the need for mechanical ventilation [11 ▪ ,12–14]. Because of the ability of the preterm infant to dilute or concentrate urine (though limited), there is an individualized range of fluid intake that allows achievement of these goals.…”

Section: Maintenance Fluid and Electrolytesmentioning

confidence: 99%

Fluid and electrolyte management in the neonate and what can go wrong

Segar,

Jetton

2023

Current Opinion in Pediatrics

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Purpose of review This review highlights recent advances in understanding fluid and electrolyte homeostasis during the newborn period, including heightened recognition of fluid overload and acute kidney injury contributing to poor clinical outcomes. Particular attention is given towards the care of extremely preterm infants. Recent findings Emerging data demonstrate (i) disproportionally large transepidermal water loss in the extremely preterm population, (ii) the relationship between postnatal weight loss (negative fluid balance) and improved outcomes, (iii) the frequency and negative effects of dysnatremias early in life, (iv) the role of sodium homeostasis in optimizing postnatal growth, and (v) the deleterious effects of fluid overload and acute kidney injury. Summary As clinicians care for an increasing number of preterm infants, understanding progress in approaches to fluid and electrolyte management and avoidance of fluid overload states will improve the care and outcomes of this vulnerable population. Further translational and clinical studies are needed to address remaining knowledge gaps and improve current approaches to fluid and electrolyte management.

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Section: Maintenance Fluid and Electrolytesmentioning

confidence: 99%