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Hidden sources like saline flushes make a significant contribution to the fluid intake of very low birthweight infants during the first postnatal week
Author(s) -
Mäkelä Pauliina M.,
Immeli Lotta,
Leskinen Markus,
RintaKoski OlliPekka,
Sund Reijo,
Andersson Sture,
Luukkainen Päivi
Publication year - 2020
Publication title -
acta paediatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/apa.15013
Subject(s) - medicine , fluid intake , gestational age , neonatal intensive care unit , saline , pediatrics , retrospective cohort study , obstetrics , anesthesia , pregnancy , surgery , genetics , biology
Aim We examined actual fluid intake, and routes of administration, in very low birthweight (VLBW) infants during the first week of life in a neonatal intensive care unit. Methods This retrospective cohort study comprised 953 infants born at <32 weeks and 1500 g and treated at Helsinki University Children's Hospital from 2005 to 2013. All parenterally and enterally administered fluids, and their sources, were obtained from our patient information system. Infants were divided into three groups according to their gestational age: 23‐26, 27‐29 and 30‐31 weeks. Results Fluid intake exceeded European guidelines during the first 3 days. On days 1‐7, total fluid intake was highest in the most premature group ( P < .001) and the median total fluid intake in this group peaked at 177 mL/kg/d (IQR 154‐209) on day three. Intravascular flushes provided a considerable source of fluids, with the median intake in the most preterm group peaking at 26.4 mL/kg/d, which represented 15.6% of total fluid intake. Conclusion During the first 3 days of life, our VLBW infants had a higher total fluid intake than the European guidelines. A considerable percentage came from hidden sources, such as saline flushes, which should be taken into account when prescribing fluids.