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Sterile water gastric drip in extremely low birthweight premature infants: a randomized trial
Clayton J Olney1, Valerie Huseby, Kathleen A Kennedy
1Pediatrix of Dallas/Fort Worth, Texas, USA.
Insights
Sterile water gavage drip (SWGD) did not reduce electrolyte imbalances in extremely low birthweight (ELBW) infants. However, SWGD showed a significant reduction in treated patent ductus arteriosus (PDA).
Area of Science:
- Neonatalogy
- Pediatric Gastroenterology
- Critical Care Medicine
Background:
- Extremely low birthweight (ELBW) infants often require careful fluid management to prevent complications.
- Hypernatremia is a concern in ELBW infants, necessitating evaluation of alternative fluid administration methods.
Purpose of the Study:
- To test if sterile water gavage drip (SWGD) reduces hypernatremia in ELBW infants.
- To assess secondary effects of SWGD on hyperkalemia, hyperglycemia, and hyperbilirubinemia.
Main Methods:
- Randomized controlled trial involving 60 ELBW infants randomized before 36 hours of age.
- Comparison between SWGD plus intravenous fluids versus conventional intravenous fluid management.
- Monitoring for electrolyte imbalances and other clinical outcomes.
Main Results:
- SWGD was well tolerated in 89% of infants.
- No significant differences were observed in the incidence of hypernatremia, hyperkalemia, hyperglycemia, or hyperbilirubinemia.
- A significant reduction in treated patent ductus arteriosus (PDA) was observed in the SWGD group (36% vs. 69%).
Conclusions:
- SWGD appears to be a safe method for administering free water to ELBW infants.
- The observed reduction in treated PDA warrants further investigation.
- SWGD may offer an alternative fluid management strategy for ELBW neonates.
Abstract:
This study was performed to test the hypothesis that sterile water gavage drip (SWGD) used in the fluid management of extremely low birthweight (ELBW) infants will decrease the incidence of hypernatremia. Secondary hypotheses included decreased hyperkalemia, hyperglycemia, and hyperbilirubinemia. Sixty ELBW infants were randomized before 36 hours of age to receive SWGD (up to 30 mL/kg/d) and intravenous fluid or conventional intravenous fluid management. SWGD was well tolerated in 89% of the infants. No difference was seen in the incidence of hypernatremia, hyperkalemia, hyperglycemia, or hyperbilirubinemia. A significant reduction in the incidence of treated patent ductus arteriosus (PDA) was noted in the study group (36% versus 69%; relative risk, 0.52; 95% confidence interval, 0.30 to 0.90; p = 0.02). SWGD may provide an alternative means of safely administering free water to the ELBW infant. The observed reduction in treated PDA requires further investigation.
