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Dexamethasone treatment and fluid balance in preterm infants at risk for chronic lung disease

A F Bos1, W A van Asselt, A Okken

  • 1Division of Neonatology, Beatrix Children's Hospital, Groningen, The Netherlands. a.f.bos@med.rug.nl

Acta Paediatrica (Oslo, Norway : 1992)
|June 14, 2000
PubMed

Insights

Dexamethasone treatment in preterm infants significantly increases urine output 48-96 hours after initiation. This effect may be due to increased arterial pressure and elevated serum urea levels, necessitating careful fluid balance monitoring.

Area of Science:

  • Neonatal Medicine
  • Pediatric Pharmacology
  • Nephrology

Background:

  • Dexamethasone is used in preterm infants, but its effect on diuresis is not well understood.
  • Preterm infants are at risk for chronic lung disease, a condition often managed with corticosteroids.

Purpose of the Study:

  • To investigate the influence of dexamethasone on urine output in preterm infants.
  • To identify potential mechanisms behind dexamethasone-induced changes in diuresis.

Main Methods:

  • A study involving 15 preterm infants (26-29 weeks gestational age) at risk for chronic lung disease.
  • Measurement of urine output, blood glucose, serum urea, creatinine, electrolytes, and arterial pressure before and during 4 days of intravenous dexamethasone treatment (0.25 mg/kg twice daily).

Main Results:

  • A significant increase in diuresis (30 ml/kg/day) was observed 48-96 hours after starting dexamethasone.
  • Concurrent increases in serum urea levels and arterial pressure were noted, while blood glucose and serum creatinine remained unchanged.
  • Fluid and protein intake were kept constant throughout the study.

Conclusions:

  • Dexamethasone administration leads to a significant increase in diuresis in preterm infants.
  • The diuresis is likely caused by pressure diuresis and increased osmolar load from elevated serum urea.
  • Close monitoring of fluid balance is recommended during the initial days of dexamethasone therapy in preterm infants.
Abstract

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