Related Experiment Video

Updated: Jul 16, 2026

A Clinical Trial Assessing the Safety, Efficacy, and Delivery of Olive-Oil-Based Three-Chamber Bags for Parenteral Nutrition
04:53

A Clinical Trial Assessing the Safety, Efficacy, and Delivery of Olive-Oil-Based Three-Chamber Bags for Parenteral Nutrition

Published on: September 20, 2019

Sodium Supplementation Algorithm to Promote Growth in Infants Who Are Preterm: Randomized Clinical Trial

Brianna M Liberio1, Gregory M Sokol1, Hannah Rakow1

  • 1Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana.

Pediatrics Open Science
|July 15, 2026
PubMed

Insights

This study found that using a urine sodium algorithm to guide sodium supplementation did not significantly improve growth in preterm infants. While the algorithm led to increased sodium intake, it did not enhance weight gain by 36 weeks postmenstrual age.

Area of Science:

  • Neonatology
  • Pediatric Nutrition
  • Clinical Trials

Background:

  • Preterm infants often require careful management of fluid and electrolyte balance.
  • Dietary sodium (Na) supplementation is crucial for growth in preterm infants, but optimal dosing strategies are debated.
  • Standard care for sodium supplementation may not always meet individual infant needs.

Purpose of the Study:

  • To evaluate the effectiveness of a novel algorithm using urine sodium concentration to guide dietary sodium supplementation in preterm infants.
  • To compare this algorithm-guided approach against standard care in promoting somatic growth.

Main Methods:

  • A randomized trial involving preterm infants (250/7 to 296/7 weeks gestation) was conducted.
  • Infants were assigned to either standard care or an algorithm-based sodium supplementation protocol starting at 14-17 days postnatal age.
  • Primary outcomes included changes in weight, length, and head circumference Z-scores from 2 weeks to 36 weeks postmenstrual age (PMA).

Main Results:

  • Infants receiving algorithm-guided supplementation received significantly more sodium (5.75 mEq/kg/d) compared to standard care (3.62 mEq/kg/d).
  • No statistically significant difference in weight Z-score change was observed between the groups at 36 weeks PMA (P = .16).
  • However, infants in the algorithm group showed a more rapid weight increase in the initial 7 weeks of the study.

Conclusions:

  • Sodium supplementation guided by urine sodium concentration did not significantly improve overall weight gain in preterm infants at 36 weeks PMA.
  • The findings suggest that while the algorithm increased sodium intake, it did not translate to superior long-term growth outcomes compared to standard care.
  • Further research may be needed to refine sodium supplementation strategies for preterm infants.
Abstract

Related Concept Videos

Drug Dosing: Infants and Children01:29

Drug Dosing: Infants and Children

Pediatric patient dosages diverge from adults due to disparities in body surface area, total body water, and extracellular fluid per kilogram of body weight. The dosing regimen considers the variations in pharmacokinetics and pharmacology across distinct age groups, encompassing preterm newborns, infants, young children, older children, and adolescents. Calculation of pediatric patient doses is predicated on determining body surface area, which exhibits a superior correlation with the child's...
Pharmacokinetics in Pediatric Patients: Drug Excretion01:26

Pharmacokinetics in Pediatric Patients: Drug Excretion

In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
Heart Failure VI: Adjunct Therapies01:22

Heart Failure VI: Adjunct Therapies

Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.
Pharmacokinetics in Pediatric Patients: Drug Distribution01:17

Pharmacokinetics in Pediatric Patients: Drug Distribution

Drug distribution in the pediatric population exhibits unique challenges and considerations due to the physiological differences between children, particularly neonates and infants, and adults. A crucial aspect of pediatric pharmacology is understanding how these differences impact the pharmacokinetics of various drugs, necessitating age-specific dosing strategies to ensure efficacy and safety.Neonates and infants have a higher total body water content, ~75%–90% of their body weight, compared...
Urinary Tract Calculi IV: Nutrition Therapy and Prevention01:27

Urinary Tract Calculi IV: Nutrition Therapy and Prevention

Management of renal calculi focuses on effective strategies like tailored nutrition and hydration therapy. Adjusting diet and fluid intake reduces stone formation and recurrence, making these interventions simple yet powerful in kidney stone prevention and management.Understanding Kidney StonesKidney stones form when calcium, oxalate, uric acid, and cystine concentrate and crystallize in urine. Factors contributing to their formation include genetic predisposition, certain medical conditions,...
Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption01:23

Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption

Understanding the physiological differences in the pediatric population is crucial for effective pharmacotherapy. Neonates, infants, and children exhibit significant variations in gastric pH, gastric emptying time, intestinal transit time, and biliary function. These variations profoundly affect oral drug absorption, necessitating a nuanced approach to pediatric dosing.Neonates present with a unique physiological profile, having a gastric pH greater than 4 and faster and more irregular gastric...