Sodium balance in premature infants
Prekajski, N.B.; Ljujić, M.; Dudić, S.; Ranković, M.
Srpski Arhiv Za Celokupno Lekarstvo 126(1-2): 6-12
1998
ISSN/ISBN: 0370-8179 PMID: 9525076 Document Number: 7646
On the basis of our study we can emphasize the following findings regarding the relation between weight gain and sodium balance. In the first group three babies started with weight gain from 6th to 10th day of life. In the second group six babies started with weight gain in the same period from 6th to 10th day. Gain weight of babies in the third group was by 3% greater in the same period compared to the birth weight, what makes a significant difference (p<0.05) group on total parenteral nutrition in comparison to the groups on supplemental nutrition. The differences in sodium intake among the groups are caused by a too small enteral sodium intake because of limited (gasbase composity) and big renal sodim losses. Total sodim intake was not increased in this period, it ranged from 1.2 to 1.58 mmol/kg/day, but renal loss was getting smaller with the maturation of tubul function. On the basis of normal urine excretion from 38 to 62 ml/kg/day, serum and urine osmolality and normal plasma sodium levels, we came to the folloowing conclusions: The studied preterm babies tolerated fluid intake from 150 to 160 ml/kg/day. Positive sodium balance was achieved by sodium intake of 2 mmol/kg/day in the group on total parenteral nutrition, and 1,5 mmol/kg/day in groups on supplemental nutrition from 5th to 10th day of life. Total fluid intake on the 5th day of life was from 130 ml/kg/day in the groups on supplemental nutrition to 150 ml/kg/day in the group on total parenteral nutrition. The time of achieving positive sodium balance coincided with the start of weight gain. Weight gain started from the 6th to the 10th day of life, when positive sodium balance was achieved from 0.70 to 0.80 mmol/kg/day which could play an important role in infants growth (23). This is the reason why it can be recommended for preterm infants from 28 to 36 gestational weeks; from the 5th day of life sodium intake should be at least from 1.5 mmol/kg/day in orally fed, and 2 mmol/kg/day in babies on total parenteral nutrition.
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