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



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Scopus ID

2-s2.0-85042628690 (requires institutional sign-in at Scopus site)   12 Citations


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 260/7 to 296/7 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 (p < 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; p < 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


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
David Segar MD Instructor in the Pediatrics department at Medical College of Wisconsin

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

Body Weight
Cohort Studies
Dietary Supplements
Gestational Age
Infant, Extremely Premature
Infant, Newborn