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Physiological Approach to Sodium Supplementation in Preterm Infants. Am J Perinatol 2018 08;35(10):994-1000

Date

02/28/2018

Pubmed ID

29486497

Pubmed Central ID

PMC6059989

DOI

10.1055/s-0038-1632366

Scopus ID

2-s2.0-85042628690

Abstract

OBJECTIVE: To implement and evaluate a clinical practice algorithm to identify preterm infants with sodium deficiency and guide sodium supplementation based on urine sodium concentrations.

STUDY DESIGN: Urine sodium concentration was measured in infants born at 26 to 29 weeks' gestation at 2-week intervals. Sodium supplementation was based on the urine sodium algorithm. Growth and respiratory outcomes in this cohort were compared with a matched cohort cared for in our neonatal intensive care unit prior to algorithm implementation (2014-2015 cohort).

RESULTS: Data were compared for 50 infants in the 2014-2015 cohort and 40 infants in the 2016 cohort. Urine sodium concentration met criteria for supplementation in 75% of the 2016 cohort infants within the first 4 weeks after birth. Average daily sodium intake was greater in the 2016 cohort compared with the 2014-2015 cohort ( < 0.05). Caloric, protein, and total fluid intakes were similar between cohorts. The change in weight Z-score between 2 and 8 weeks of age was significantly greater in the 2016 versus 2014-2015 cohort (0.32 ± 0.05 vs. -0.01 ± 0.08;  < 0.01). No impact on respiratory status at 28 days of age or 36 weeks of postmenstrual age was identified.

CONCLUSION: Institution of a clinical practice algorithm to instruct clinicians on sodium supplementation in preterm infants may improve growth outcomes.

Author List

Segar DE, Segar EK, Harshman LA, Dagle JM, Carlson SJ, Segar JL

Authors

Jeffrey L. Segar MD Professor in the Pediatrics department at Medical College of Wisconsin
Elizabeth Segar MD Assistant Professor in the Pediatrics department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Algorithms
Body Weight
Cohort Studies
Dietary Supplements
Female
Gestational Age
Humans
Hyponatremia
Infant
Infant, Extremely Premature
Infant, Newborn
Male
Sodium
jenkins-FCD Prod-400 0f9a74600e4e79798f8fa6f545ea115f3dd948b2