Related Experiment Video
Updated: Oct 18, 2026
Development of a Neonatal Piglet Acute Lung Injury Model Recreating the Early Environment of Preterm Infant Lungs
Published on: October 31, 2025
Comparison of the effect of two fluid input regimens on perinatal lung function in ventilated infants of very low
V Kavvadia1, A Greenough, G Dimitriou
1Children Nationwide Regional Neonatal Intensive Care Centre, 4th floor, Ruskin Wing, King's College Hospital, London SE5 9RS, UK.
Insights
Early fluid restriction in premature infants did not significantly improve lung function. While some minor differences were observed, overall, fluid management had minimal impact on respiratory outcomes for these vulnerable newborns.
Area of Science:
- Neonatology
- Pediatric Respiratory Medicine
- Critical Care
Background:
- Fluid overload is a known risk factor for respiratory failure in infants.
- Fluid restriction has been linked to improved survival without chronic lung disease.
- Optimizing fluid management is crucial for improving lung function in premature infants.
Purpose of the Study:
- To investigate the impact of fluid restriction on perinatal lung function in ventilated, very low birthweight premature infants.
- To compare the effects of two different fluid regimens on lung function parameters.
- To determine if early fluid restriction can enhance lung function in this vulnerable population.
Main Methods:
- A randomized trial comparing two fluid regimens: a standard regimen and a restricted regimen (approx. 25% less fluid).
- Lung function assessed daily by measuring functional residual capacity (FRC) and compliance in 90 premature infants (median gestational age 28 weeks).
- Measurements taken on days 1-5 and day 7 post-birth.
Main Results:
- Infants in the restricted fluid group received significantly less fluid (P < 0.01).
- A transient increase in mean compliance was observed in the restricted group on day 3, but this difference reversed later.
- Colloid intake negatively correlated with both functional residual capacity (FRC) and compliance (P=0.003 and P=0.001, respectively).
Conclusions:
- Early fluid restriction demonstrated minimal impact on perinatal lung function in ventilated, premature infants.
- The study suggests that fluid restriction alone may not be sufficient to significantly alter lung function outcomes.
- Colloid administration was identified as a factor negatively affecting lung function.
Unlabelled:
Fluid overload worsens respiratory failure; conversely, fluid restriction has been associated with a higher survival rate without chronic lung disease. We therefore hypothesised that fluid restriction in the perinatal period might improve lung function in ventilated, prematurely born infants of very low birthweight. As a consequence, we compared in a randomised trial the effect of two fluid regimes on perinatal lung function. On one regime infants were to receive 60 ml/kg on day 1, increasing to 150 ml/kg by day 7, and on the other regime approximately 25% less fluid was to be prescribed. Lung function was assessed by measurement of functional residual capacity (FRC) and compliance. Measurements were made daily on days 1 to 5 and then on day 7. Ninety infants, median gestational age 28 weeks (range 23-33), were included in the study. There were no significant differences between the two groups regarding their gestational age or birthweight, or in the proportions who received antenatal steroids or postnatal surfactant. The infants on the restricted regime received significantly less fluid (P < 0.01). The only significant differences in lung function between the two groups, however, were that the infants on the restricted regime had a higher mean compliance on day 3, but thereafter the difference was reversed. Colloid intake, however, unfavourably affected lung function, total colloid intake being negatively correlated with both the area under the curve of birth-adjusted FRC (P=0.003) and compliance (P=0.001).
Conclusion:
We conclude that early fluid restriction appears to have very little impact on perinatal lung function.
