Sodium normal range in infants12/10/2023 Thus, the present study aimed to review sodium imbalance in VLBWI seen in Charlotte Maxeke Johannesburg Academic Hospital (CMJAH) in Johannesburg, South Africa. There is scant data regarding sodium balance in VLBWI in South Africa. Hyponatraemia is defined as plasma sodium <130 mmol/l.( 6, 8) Water retention may be a more important cause of hyponatraemia in the VLBWI than sodium losses.( 1, 10) Hyponatraemia may be due to excessive fluid and water/salt administration (iatrogenic) or due to impaired tubular sodium reabsorption.( 11, 12) Hyponatraemia is associated with delayed growth, poor neurodevelopmental outcome,( 13, 14) increased risk of PDA, bronchopulmonary dysplasia, IVH, NEC ( 15) and neurosensory hearing loss.( 16) Sodium is required to maintain extracellular tonicity and positive sodium balance is a prerequisite for growth.įluid and electrolyte management in very low-birthweight infants (VLBWI) birthweight 145 mmol/l.( 1, 6) In VLBWI, insensible water loss (IWL) and renal immaturity are the major contributing factors to hypernatraemia.( 7) Factors affecting IWL in VLBWI are increased respiratory rate, surgical malformations (gastroschisis and omphalocoele), increased body temperature, use of radiant warmer and phototherapy.( 6) Hypernatraemia is associated with an increased incidence of chronic lung disease (CLD), patent ductus arteriosus (PDA), necrotizing enterocolitis (NEC) ( 8) and intraventricular haemorrhage (IVH).( 7) Very severe hypernatraemia is associated with poor neurological outcome.( 8) It has thus been recommended that more emphasis on fluid and electrolyte therapy in VLBWI should be placed on the prevention of excessive insensible water loss rather than the replacement of insensible water loss.( 9) Prevention of prematurity and measures to prevent sodium abnormalities should be implemented at birth, especially in very small preterm infants to decrease the mortality and morbidity. The main causes of hypernatraemia were insensible water loss through the skin (73.9% of babies born via normal vaginal delivery) and respiratory system (60% of babies were on continuous positive airway pressure (CPAP)).Ĭonclusion: Hypernatraemia is common in the first week of life in VLBWI. Within the hypernatraemic VLBWI, mortality was significantly increased in much smaller and more preterm infants (p < 0.001) and in infants with higher sodium levels (p < 0.005). There was no difference in birthweight or gestational age between hyponatraemic and hypernatraemic VLBWI. Results: Sodium imbalances were found in 29.1% (85/292) VLBWI. The causes and complications associated with sodium abnormalities and their outcomes were reviewed. Subjects included all VLBWI born at Charlotte Maxeke Johannesburg Academic Hospital between 1 January 2013 and 31 July 2013. Methods: This was a retrospective cross-sectional descriptive study evaluating sodium abnormalities in VLBWI in the first week of life. Objective: To determine the incidence and outcomes of both hypo- and hypernatraemia in VLBWI (500–1500 g birthweight) in the first week of life. Lastly, we provide evidence-based gestational and postnatal age-dependent recommendations for the provision of adequate sodium intake to preterm neonates.Background: Sodium imbalance is common in the first week of life in very low-birthweight infants (VLBWI) and may be associated with poor outcome. The hormonal regulation of sodium homeostasis is here reviewed and the mechanism accounting for sodium deficiency-induced growth impairment in preterm infants addressed. A low urinary sodium content is accepted by many as reflecting total body sodium deficiency, yet spot urinary sodium measurements are of questionable clinical value. As addressed in this review, there is a lack of consensus on the definition of hyponatremia early in life, but there is no evidence that it should deviate from the widely accepted normative data for adult subjects. The provision of an adequate sodium intake to preterm neonates is hampered by the technical difficulty in clinically assessing total body sodium content. It is widely accepted that sodium is an essential nutritional electrolyte and its deficiency is associated with neurological sequelae and poor growth.
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