Early sodium and fluid intake and severe intraventricular hemorrhage in extremely low birth weight infants.
Hypernatremic dehydration is an important cause of intracranial hemorrhage. A possible association of intraventricular hemorrhage (IVH) with hypernatremia and/or high sodium intake has been suggested in preterm infants. To investigate the associations of early fluid and sodium intake or serum sodium concentrations with severe intraventricular hemorrhage (IVH) in extremely low birth weight (ELBW) infants, we reviewed the medical records of 169 inborn ELBW infants. Daily fluid and sodium intake, urine output, weight loss and serum sodium concentration during the first 4 days of life were obtained. Patients were divided into the severe IVH (grade 3/4) and the control (no or grade 1/2 IVH) group. The maximum serum sodium concentration and the incidence of hypernatremia did not differ between the two groups. Related to the fluid balance and sodium intake, the risk for severe IVH was strongly associated with total fluid and sodium intake during the initial four days of life. With respect to the fluids other than transfusion, severe IVH can be discriminated only by sodium intake but not by fluid intake. Large randomized controlled trials are required to clarify the causal relationship between the early sodium intake and severe IVH in ELBW infants.
Department of Pediatrics, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
Hye Jin
0000-0002-3785-4638
HJ
Lee
Department of Pediatrics, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
Byong Sop
0000-0002-1347-4200
BS
Lee
Department of Pediatrics, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
Hyun-Jeong
0000-0002-5174-5032
HJ
Do
Department of Pediatrics, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
Seong-Hee
0000-0002-4499-6650
SH
Oh
Department of Pediatrics, Kyung Hee University School of Medicine, Seoul, Korea.
Yong-Sung
0000-0001-9181-7849
YS
Choi
Department of Pediatrics, Kyung Hee University School of Medicine, Seoul, Korea.
Sung-Hoon
0000-0002-0352-9722
SH
Chung
Department of Pediatrics, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
Ellen Ai-Rhan
0000-0002-9859-3021
EA
Kim
Department of Pediatrics, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
Ki-Soo
0000-0003-1547-5220
KS
Kim
D001724:Birth Weight; D003681:Dehydration; D004326:Drinking; D006352:Heart Ventricles / Q000473:pathology*; D006470:Hemorrhage / Q000401:mortality / Q000473:pathology*; D006801:Humans; D006955:Hypernatremia / Q000097:blood*; D007223:Infant; D007226:Infant Mortality; D052577:Infant, Extremely Low Birth Weight / Q000097:blood*; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000453:epidemiology; D012189:Retrospective Studies; D012964:Sodium / Q000097:blood*; D012982:Sodium, Dietary
D012982:Sodium, Dietary; D012964:Sodium
Fluid Therapy; Hypernatremia; Infant, Extremely Low Birth Weight; Infant, Premature; Intraventricular Hemorrhage; Sodium