Insensible Water Loss during the First Week of Life of Extremely Low Birth Weight Infants Less than 25 Gestational Weeks under High Humidification. |
Se In Sung, So Yoon Ahn, Hyun Joo Seo, Hye Soo Yoo, Young Mi Han, Myung Sook Lee, Yun Sil Chang, Won Soon Park |
1Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. wonspark@skku.edu 2Department of Pediatrics, Myongji Hospital, Kwandong University College of Medicine, Goyang, Korea. |
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Abstract |
PURPOSE Extremely-low-birth-weight infants (ELBWIs), especially those < or =24 gestational weeks (GW), presented extremes in IWL and changes of water balance. The purpose of the present study was to retrospectively investigate fluid and electrolyte balance in infants of < or =24-GW during the first postnatal week under high humidification. METHODS Medical records of extremely-low-birth-weight infants (ELBWIs) who were born and admitted to the Neonatal Intensive Care Unit at Samsung Medical Center during March 2004-September 2010 were reviewed. Fluid intake, urine output, insensible water loss (IWL) and electrolyte balance of 22-GW (n=14), 23-GW (n=40) and 24-GW (n=67) infants nursed in high humidity (95%) were compared with > or =26-GW (n=65) infants nursed in 60% humidity. RESULTS Survival rate until discharge was 33%, 82%, 75% and 89.3% in 22-GW, 23-GW, 24-GW and > or =26-GW infants, respectively. Compared to > or =26-GW infants, fluid intake and IWL was higher in 22-GW and 23-WG, but not as different in 24-GW. At postnatal day (P) 3-5, urine output was significantly lower in > or =26-GW infants than in the other age groups. Serum sodium level was significantly higher in 22-, 23- and 24-GW (P1-2) than in > or =26-GW infants.
Hypernatremia (>150 mEq/dl sodium) was more frequent in 22-GW (71%), 23-GW (41%) and 24-GW (21%) than in > or =26-GW infants (14%). CONCLUSION High-humidity environments significantly decreased fluid intake and improved electrolyte imbalance in 24-GW, but not in 22- and 23-GW infants. Increased IWL in the latter might be related to more immature skin, implicating the need for additional nurturing conditions. |
Key Words:
Electrolytes; Extremely-low-birth-weight infant; Humidity; Insensible water loss |
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