title: Hemodynamic effects of fluid restriction in preterm infants with significant patent ductus arteriosus.
abstract: OBJECTIVE
  To determine the hemodynamic impact of fluid restriction in preterm newborns with significant patent ductus arteriosus.
  
  
  METHODS
  Newborns ≥24 and <32 weeks' gestational age with significant patent ductus arteriosus were eligible for this prospective multicenter observational study. We recorded hemodynamic and Doppler echocardiographic variables before and 24 hours after fluid restriction.
  
  
  RESULTS
  Eighteen newborns were included (gestational age 24.8 ± 1.1 weeks, birth weight 850 ± 180 g). Fluid intake was decreased from 145 ± 15 to 108 ± 10 mL/kg/d. Respiratory variables, fraction of inspired oxygen, blood gas values, ductus arteriosus diameter, blood flow-velocities in ductus arteriosus, in the left pulmonary artery and in the ascending aorta, and the left atrial/aortic root ratio were unchanged after fluid restriction. Although systemic blood pressure did not change, blood flow in the superior vena cava decreased from 105 ± 40 to 61 ± 25 mL/kg/min (P < .001). The mean blood flow-velocity in the superior mesenteric artery was lower 24 hours after starting fluid restriction.
  
  
  CONCLUSIONS
  Our results do not support the hypothesis that fluid restriction has beneficial effects on pulmonary or systemic hemodynamics in preterm newborns.
authors.affiliation: Neonatal Intensive Care Unit, Hôpital Universitaire des Enfants Reine Fabiola, Brussels, Belgium.
authors.forename: Julie
authors.initials: J
authors.lastname: De Buyst
authors.forename: Thameur
authors.initials: T
authors.lastname: Rakza
authors.forename: Thomas
authors.initials: T
authors.lastname: Pennaforte
authors.forename: Anne-Britt
authors.initials: AB
authors.lastname: Johansson
authors.forename: Laurent
authors.initials: L
authors.lastname: Storme
mesh_terms: D004374:Ductus Arteriosus, Patent / Q000503:physiopathology*; D015150:Echocardiography, Doppler; D006439:Hemodynamics; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000503:physiopathology*; D008168:Lung / Q000503:physiopathology; D011446:Prospective Studies; D011651:Pulmonary Artery / Q000503:physiopathology; D012039:Regional Blood Flow / Q000502:physiology; D014683:Vena Cava, Superior / Q000503:physiopathology; D014867:Water / Q000008:administration & dosage*
chemical_list: D014867:Water