J Skillman1, A Cole, R Slator. 1. Birmingham Children's Hospital, Birmingham, United Kingdom. joskillman@doctors.org.uk
Abstract
OBJECTIVE: To investigate whether sodium supplementation increases weight gain in babies with grade 3 Pierre Robin sequence if their urinary sodium is low. DESIGN: Retrospective review of all medical, dietitian, and nursing notes of babies admitted from 2000 to 2007, inclusive. SETTING: Tertiary center for cleft care. PATIENTS: A total of 33 babies requiring nasogastric and nasopharangeal intubation for Pierre Robin sequence were identified. Those for whom weights could not be measured accurately (n = 4) were excluded from further study. INTERVENTIONS: Urinary sodium was low and weight gain poor in 21 of the remaining 29 babies (72%), and oral sodium supplementation was given to establish and maintain a normal urinary sodium (10 to 20 mmol/L). MAIN OUTCOME MEASURE: Mean daily weight gain. RESULTS: The mean daily weight gain of the 18 babies with low urinary sodium admitted in the first few days of life improved from 20 to 34 g (p < .001) following oral sodium supplementation. This gave a mean difference of 14 g (lower quartile = 6 g, upper quartile = 25 g, 95% confidence interval = 20, 90% confidence interval = 10). The mean daily weight gain of the eight patients who did not require sodium supplementation was 33.6 g. CONCLUSIONS: Urinary sodium tests are simple and noninvasive and allow monitoring of urinary sodium. If low, adequate supplementation improved weight gain (p < .001), reversing failure to thrive in babies with severe Pierre Robin sequence. These findings have been unreported previously.
OBJECTIVE: To investigate whether sodium supplementation increases weight gain in babies with grade 3 Pierre Robin sequence if their urinary sodium is low. DESIGN: Retrospective review of all medical, dietitian, and nursing notes of babies admitted from 2000 to 2007, inclusive. SETTING: Tertiary center for cleft care. PATIENTS: A total of 33 babies requiring nasogastric and nasopharangeal intubation for Pierre Robin sequence were identified. Those for whom weights could not be measured accurately (n = 4) were excluded from further study. INTERVENTIONS: Urinary sodium was low and weight gain poor in 21 of the remaining 29 babies (72%), and oral sodium supplementation was given to establish and maintain a normal urinary sodium (10 to 20 mmol/L). MAIN OUTCOME MEASURE: Mean daily weight gain. RESULTS: The mean daily weight gain of the 18 babies with low urinary sodium admitted in the first few days of life improved from 20 to 34 g (p < .001) following oral sodium supplementation. This gave a mean difference of 14 g (lower quartile = 6 g, upper quartile = 25 g, 95% confidence interval = 20, 90% confidence interval = 10). The mean daily weight gain of the eight patients who did not require sodium supplementation was 33.6 g. CONCLUSIONS: Urinary sodium tests are simple and noninvasive and allow monitoring of urinary sodium. If low, adequate supplementation improved weight gain (p < .001), reversing failure to thrive in babies with severe Pierre Robin sequence. These findings have been unreported previously.
Authors: Emma C Paes; Iris A C de Vries; Wouter M Penris; Karlijn H Hanny; Selma W Lavrijsen; Elselien K van Leerdam; Maaike M Rademaker; Esther S Veldhoen; Rene M J C Eijkemans; Moshe Kon; Corstiaan C Breugem Journal: Clin Oral Investig Date: 2016-11-21 Impact factor: 3.573