Cornelia Späth1, Elisabeth Stoltz Sjöström2, Fredrik Ahlsson3, Johan Ågren3, Magnus Domellöf1. 1. Department of Clinical Sciences, Pediatrics, Umeå University, Umeå, Sweden. 2. Department of Food and Nutrition, Umeå University, Umeå, Sweden. 3. Department of Women´s and Children´s Health, Uppsala University, Uppsala, Sweden.
Abstract
BACKGROUND: Hyper- and hyponatremia occur frequently in extremely preterm infants. Our purpose was to investigate plasma sodium (P-Na) concentrations, the incidence of hyper- and hyponatremia, and the impact of possible predisposing factors in extremely preterm infants. METHODS: In this observational study, we analyzed data from the EXtremely PREterm (< 27 wk.) infants in Sweden Study (EXPRESS, n = 707). Detailed nutritional, laboratory, and weight data were collected retrospectively from patient records. RESULTS: Mean ± SD P-Na increased from 135.5 ± 3.0 at birth to 144.3 ± 6.1 mmol/l at a postnatal age of 3 d and decreased thereafter. Fifty percent of infants had hypernatremia (P-Na > 145 mmol/l) during the first week of life while 79% displayed hyponatremia (P-Na < 135 mmol/l) during week 2. Initially, the main sodium sources were blood products and saline injections/infusions, gradually shifting to parenteral and enteral nutrition towards the end of the first week. The major determinant of P-Na and the risks of hyper- and hyponatremia was sodium supply. Fluid volume provision was associated with postnatal weight change but not with P-Na. CONCLUSION: The supply of sodium, rather than fluid volume, is the major factor determining P-Na concentrations and the risks of hyper- and hyponatremia.
BACKGROUND:Hyper- and hyponatremia occur frequently in extremely preterm infants. Our purpose was to investigate plasma sodium (P-Na) concentrations, the incidence of hyper- and hyponatremia, and the impact of possible predisposing factors in extremely preterm infants. METHODS: In this observational study, we analyzed data from the EXtremely PREterm (< 27 wk.) infants in Sweden Study (EXPRESS, n = 707). Detailed nutritional, laboratory, and weight data were collected retrospectively from patient records. RESULTS: Mean ± SD P-Na increased from 135.5 ± 3.0 at birth to 144.3 ± 6.1 mmol/l at a postnatal age of 3 d and decreased thereafter. Fifty percent of infants had hypernatremia (P-Na > 145 mmol/l) during the first week of life while 79% displayed hyponatremia (P-Na < 135 mmol/l) during week 2. Initially, the main sodium sources were blood products and saline injections/infusions, gradually shifting to parenteral and enteral nutrition towards the end of the first week. The major determinant of P-Na and the risks of hyper- and hyponatremia was sodium supply. Fluid volume provision was associated with postnatal weight change but not with P-Na. CONCLUSION: The supply of sodium, rather than fluid volume, is the major factor determining P-Na concentrations and the risks of hyper- and hyponatremia.
Authors: Elisabeth Stoltz Sjöström; Inger Öhlund; Fredrik Ahlsson; Eva Engström; Vineta Fellman; Ann Hellström; Karin Källén; Mikael Norman; Elisabeth Olhager; Fredrik Serenius; Magnus Domellöf Journal: Acta Paediatr Date: 2013-08-06 Impact factor: 2.299
Authors: Abby M Basalely; Russell Griffin; Katja M Gist; Ronnie Guillet; David J Askenazi; Jennifer R Charlton; David T Selewski; Mamta Fuloria; Frederick J Kaskel; Kimberly J Reidy Journal: J Perinatol Date: 2021-11-13 Impact factor: 3.225
Authors: Cornelia Späth; Elisabeth Stoltz Sjöström; Johan Ågren; Fredrik Ahlsson; Magnus Domellöf Journal: Acta Paediatr Date: 2022-06-10 Impact factor: 4.056