A dynamic approach to fluid and electrolyte management of the newborn

The most constant feature of neonatal physiology and pathophysiology is change. To meet the needs of each individual baby we must first arm ourselves with knowledge of neonatal physiology and pathophysiology. Next, the effects of the applied fluid program are continually monitored and the program accordingly readjusted. We must "read the book" and then "read the baby." This paper discusses the results of "reading the book" and proposes a tentative dynamic fluid and electrolyte program. The "reading of the baby" is beyond the scope of this paper, but should be simple, utilizing commonly available methods that can safely be done as frequently as every four to eight hours including repeated physical examinations, simple laboratory tests in blood and urine, and the determination of the body weight.