Related Experiment Video
Updated: Jun 29, 2025
A Rat Model of Mild Intrauterine Hypoperfusion with Microcoil Stenosis
Published on: January 7, 2018
Excessive sodium supplementation but not fluid load is correlated with overall morbidity in extremely low birth
Konrad Becker1, Hera Becker1, Teresa Riedl-Seifert1
1Department of Neonatology and Paediatric Gastroenterology Children's Hospital Kassel Kassel Germany.
Insights
Excessive sodium intake in extremely low birth weight infants often exceeds recommendations, increasing morbidity. Careful monitoring and identification of inadvertent sodium sources are crucial for improved infant outcomes.
Area of Science:
- Neonatalogy
- Pediatric Nephrology
- Clinical Nutrition
Background:
- Maintaining sodium balance is vital for extremely low birth weight (ELBW) infants' growth and development.
- Imbalances in sodium levels, whether deficient or excessive, can lead to significant health complications in ELBW neonates.
Purpose of the Study:
- To evaluate sodium and fluid management practices in ELBW infants during the initial two weeks of life.
- To determine the association between sodium intake and morbidity in ELBW infants.
- To identify sources of inadvertent sodium exposure in ELBW infants.
Main Methods:
- A retrospective, single-center study included ELBW infants born between June 2017 and May 2019.
- Data on sodium and fluid administration, serum sodium levels, and infant outcomes were collected and analyzed.
- Statistical analysis, including logistic regression, was used to assess correlations between sodium intake and morbidity.
Main Results:
- Mean sodium intake in ELBW infants exceeded European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) guidelines.
- Increased sodium intake was significantly associated with higher incidences of patent ductus arteriosus (PDA), intraventricular hemorrhage (IVH), and retinopathy of prematurity (ROP).
- Arterial line administration of 0.9% saline was a primary source of inadvertent sodium. A predictive model for serum sodium changes was developed.
Conclusions:
- Sodium administration frequently surpasses established recommendations for ELBW infants, contributing to increased morbidity.
- Efforts to pinpoint and reduce inadvertent sodium sources are essential to mitigate associated health risks in this vulnerable population.
Objectives:
Sodium homeostasis in extremely low birth weight (ELBW) infants is critical. While a lack of sodium delays growth, excessive supplementation increases morbidity.
Methods:
We performed a single-center retrospective study on sodium and fluid management during the first 2 weeks of live including all ELBW infants born between June 1, 2017 and May 31, 2019.
Results:
Forty-seven patients (median GA 26 + 6 weeks, median BW 845 g) were included. Mean sodium intake was above the ESPGHAN recommendation, 4.58 mmol/kg/day during the first 2 days and 1.99 mmol/kg/day during the following period. Incidence of PDA, IVH, and ROP was directly associated with sodium intake (OR 1.6, 1.3, and 1.4, respectively), but not with fluid supplementation. No association to BPD was found. The most important source for inadvertent sodium intake were 0.9% saline given by arterial lines. Sodium supplementation did not correlate directly with serum sodium levels, but a linear regression model combining sodium intake and fluid supplementation was able to predict serum sodium changes 24-48 h in advance (correlation coefficient of 0.294, p < 0.05).
Conclusions:
Sodium application substantially exceeded ESPGHAN recommendations in ELBW infants. An excess in sodium was associated with an overall increased morbidity, justifying increased efforts to identify inadvertent sodium sources in these patients with the aim to decrease sodium excess.
More Related Videos
07:36Modeling Encephalopathy of Prematurity Using Prenatal Hypoxia-ischemia with Intra-amniotic Lipopolysaccharide in Rats
Published on: November 20, 2015
09:36Effect of Hyaluronic Acid 35 kDa on an In Vitro Model of Preterm Small Intestinal Injury and Healing Using Enteroid-Derived Monolayers
Published on: July 28, 2022
Related Concept Videos
01:29Disorder of Water Balance
Dehydration
Dehydration occurs when the body loses fluids (particularly water).
Causes:
The major causes of dehydration include excessive sweating, fever, vomiting, diarrhea, and diuresis.
Signs and Symptoms:
Symptoms primarily include intense...
01:28Antihypertensive Drugs: Potassium-Sparing Diuretics
01:21Overview of Protein Metabolism
Amino acids play various roles in the body once they are absorbed into cells. They are restructured...
01:25Regulation of Water Intake
02:02Responses to Salt Stress
01:24Renal Tubule and Collecting Duct
Proximal Convoluted Tubule (PCT):
The PCT is the initial segment of the renal tubule, extending from the Bowman's capsule that encloses the glomerulus. Its convoluted structure and microvilli-lined cells increase the surface area for reabsorption. The PCT reabsorbs glucose, amino acids, sodium, and water from the filtrate, ensuring essential...