Christopher S Monnikendam1, Thornton S Mu2, James K Aden3, William Lefkowitz4, Nicholas R Carr5, Christine N Aune6, Kaashif A Ahmad6. 1. Department of Pediatrics, Naval Medical Center Portsmouth, Portsmouth, VA, USA. 2. Department of Pediatrics, Brooke Army Medical Center, San Antonio, TX, USA. thornton.s.mu.mil@mail.mil. 3. Department of Graduate Medical Education, Brooke Army Medical Center, San Antonio, TX, USA. 4. Department of Pediatrics, Tripler Army Medical Center, Honolulu, HI, USA. 5. Department of Pediatrics, Brooke Army Medical Center, San Antonio, TX, USA. 6. Pediatrix Medical Group, San Antonio, TX, USA.
Abstract
OBJECTIVE: The objective of this study is to discern patterns of serum sodium in a broad cohort of extremely low birth weight (ELBW) infants and associate those patterns with hospital outcomes. STUDY DESIGN: Retrospective cohort study of ELBW infants from 323 neonatal intensive care units (NICUs) discharged from 2004 to 2014. We included patients who survived at least 7 days and had daily sodium levels available, and categorized infants by their minimum and maximum sodium levels. RESULTS: We identified 26,871 infants of whom 12,428 met inclusion criteria. Only 1964 (15.8%) maintained eunatremia for the first week. We found most dysnatremias to be associated with increased overall mortality compared with eunatremic patients including moderate hyponatremia (12.9% vs. 8.6%, p < 0.05) and severe hypernatremia (34.8% vs. 8.6%, p < 0.001). Most of these associations were maintained after regression modeling for mortality. CONCLUSION: Sodium fluctuations occurring within the first week of life are associated with increased mortality.
OBJECTIVE: The objective of this study is to discern patterns of serum sodium in a broad cohort of extremely low birth weight (ELBW) infants and associate those patterns with hospital outcomes. STUDY DESIGN: Retrospective cohort study of ELBW infants from 323 neonatal intensive care units (NICUs) discharged from 2004 to 2014. We included patients who survived at least 7 days and had daily sodium levels available, and categorized infants by their minimum and maximum sodium levels. RESULTS: We identified 26,871 infants of whom 12,428 met inclusion criteria. Only 1964 (15.8%) maintained eunatremia for the first week. We found most dysnatremias to be associated with increased overall mortality compared with eunatremic patients including moderate hyponatremia (12.9% vs. 8.6%, p < 0.05) and severe hypernatremia (34.8% vs. 8.6%, p < 0.001). Most of these associations were maintained after regression modeling for mortality. CONCLUSION:Sodium fluctuations occurring within the first week of life are associated with increased mortality.
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