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Sodium supply influences plasma sodium concentration and the risks of hyper- and hyponatremia in extremely preterm

Cornelia Späth1, Elisabeth Stoltz Sjöström2, Fredrik Ahlsson3

  • 1Department of Clinical Sciences, Pediatrics, Umeå University, Umeå, Sweden.

Pediatric Research
|December 10, 2016
PubMed

Insights

Plasma sodium levels in extremely preterm infants are primarily influenced by sodium supply, not fluid volume. This finding is crucial for managing hypernatremia and hyponatremia risks in this vulnerable population.

Area of Science:

  • Neonatalogy
  • Pediatric Nephrology
  • Clinical Chemistry

Background:

  • Extremely preterm infants frequently experience abnormal plasma sodium concentrations, specifically hypernatremia and hyponatremia.
  • Understanding the factors influencing these electrolyte imbalances is critical for optimizing infant care.

Purpose of the Study:

  • To investigate plasma sodium (P-Na) concentrations in extremely preterm infants.
  • To determine the incidence of hypernatremia and hyponatremia.
  • To identify predisposing factors affecting P-Na levels.

Main Methods:

  • Observational study utilizing data from the EXtremely PREterm (EXPRESS) infants in Sweden Study (n=707).
  • Retrospective collection of detailed nutritional, laboratory, and weight data from patient records.
  • Analysis of P-Na trends and correlation with sodium supply and fluid volume.

Main Results:

  • Mean P-Na increased initially then decreased, with significant hypernatremia (50%) and hyponatremia (79%) observed in the first two weeks.
  • Sodium supply from various sources (blood products, nutrition) was the primary determinant of P-Na.
  • Fluid volume provision correlated with postnatal weight changes but not P-Na levels.

Conclusions:

  • Sodium supply is the dominant factor influencing P-Na concentrations in extremely preterm infants.
  • Management strategies should prioritize careful control of sodium administration.
  • Fluid balance alone does not adequately predict or manage sodium disturbances.
Abstract

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