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Normal Anion-Gap Metabolic Acidosis in an Extremely Preterm Neonate

Ambalakkuthan Murugesan1, Sandesh Cs2

  • 1Department of Neonatology, Jawaharlal Nehru Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, 605006, India. murugesan89@gmail.com.

Indian Journal of Pediatrics
|December 9, 2022
PubMed

Insights

Extremely preterm neonates face metabolic risks like acidosis. This study details an uncommon cause of hyperchloremic metabolic acidosis in an extremely preterm infant, highlighting the need for tailored nutritional strategies.

Area of Science:

  • Neonatology
  • Pediatric Endocrinology
  • Clinical Nutrition

Background:

  • Extremely preterm neonates (<28 weeks) are susceptible to metabolic complications including hypocalcemia, hypophosphatemia, hyponatremia, and metabolic acidosis.
  • These issues often stem from prematurity itself or prolonged parenteral nutrition, with some complications persisting beyond initial hospital weeks.
  • Optimizing enteral nutrition with fortification is crucial for growth and managing these metabolic disturbances.

Purpose of the Study:

  • To report an uncommon cause of hyperchloremic metabolic acidosis in an extremely preterm neonate.
  • To contribute to the understanding of metabolic complications in extremely preterm infants.

Main Methods:

  • Case report of an extremely preterm neonate.
  • Clinical assessment and laboratory investigations.
  • Nutritional management review.

Main Results:

  • The neonate presented with hyperchloremic metabolic acidosis, an unusual etiology in this population.
  • The specific cause identified was previously unreported in the literature for extremely preterm infants.

Conclusions:

  • Hyperchloremic metabolic acidosis can occur due to uncommon causes in extremely preterm neonates.
  • Early recognition and appropriate nutritional management are vital for addressing metabolic imbalances in this vulnerable group.

Keywords:
Hyperchloremic acidosisLate-onset hyponatremia (LOH)Postnatal growth of preterm infantsSodium supplementation

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