Hyperosmolality and intraventricular haemorrhage in premature babies

Serial investigations of electrolytes, osmolality and nutritional status were undertaken in 28 babies less than 33 weeks gestation. 6 died with intraventricular haemorrhage, 9 died without intraventricular haemorrhage, and 13 survived. Significant hypersomality was detected in the babies who died with intraventricular haemorrhage, whereas babies who died without intraventricular haemorrhage and survivors had values within normal limits. No relation was found between hyperosmolality and sodium concentrations. Total fluid intake and caloric intake were comparable in the three groups, but protein intake was much reduced in babies with intraventricular haemorrhage due to a lower milk intake. The hyperosmolality could have resulted from tissue breakdown following protein starvation and may be a factor in the occurrence of intraventricular haemorrhage. In premature babies an osmolality of over 320 mOsm/l carried a grave prognostic implication.