FETAL AND NEONATAL MEDICINE
Sodium restriction versus daily maintenance replacement in very low birth weight premature neonates: A randomized, blind therapeutic trial A n d r e w T. Costarino, Jr., MD, J e f f r e y A. Gruskay, MD, Linda C o r c o r a n , RN, Richard A. Polin, MD, a n d S t e p h e n B a u m g a r t , MD From the Divisions of Critical Care Medicine and Neonatotogy, the Department of Anesthesiology and Critical Care Medicine and the Department of Pediatrics, University of Pennsylvania School of Medicine and Children's Hospital of Philadelphia, Philadelphia, Pennsylvania To test the hypothesis that restriction of sodium intake during the first 3 to 5 days of life will prevent the o c c u r r e n c e of hypernatremia and the n e e d for administration of large fluid volumes, we prospectively and randomly assigned 17 babies (mean _ SD: 850 + 120 gm; 27 _+ I weeks of gestation) to receive in blind fashion either daily m a i n t e n a n c e sodium or salt restriction with physician-prescribed parenteral fluid intake. M a i n t e n a n c e - g r o u p infants received 3 to 4 mEq of sodium per kilogram per day; restricted infants received no sodium supplement other than with such treatments as transfusion. Sodium b a l a n c e studies c o n d u c t e d for 5 days demonstrated that m a i n t e n a n c e salt intake resulted in a daily sodium b a l a n c e near zero, whereas sodium-restricted infants c o n t i n u e d to e x c r e t e urinary sodium at a high rate, which p r o m o t e d a more n e g a t i v e b a l a n c e ( a v e r a g e daily sodium b a l a n c e - 0 . 3 0 _+ 1.78 SD in m a i n t e n a n c e group vs -3.71 _+ 1.47 mEq/kg per d a y in restriction group; p
Sodium restriction versus daily maintenance replacement in very low birth weight premature neonates: A randomized, blind therapeutic trial A n d r e w T. Costarino, Jr., MD, J e f f r e y A. Gruskay, MD, Linda C o r c o r a n , RN, Richard A. Polin, MD, a n d S t e p h e n B a u m g a r t , MD From the Divisions of Critical Care Medicine and Neonatotogy, the Department of Anesthesiology and Critical Care Medicine and the Department of Pediatrics, University of Pennsylvania School of Medicine and Children's Hospital of Philadelphia, Philadelphia, Pennsylvania To test the hypothesis that restriction of sodium intake during the first 3 to 5 days of life will prevent the o c c u r r e n c e of hypernatremia and the n e e d for administration of large fluid volumes, we prospectively and randomly assigned 17 babies (mean _ SD: 850 + 120 gm; 27 _+ I weeks of gestation) to receive in blind fashion either daily m a i n t e n a n c e sodium or salt restriction with physician-prescribed parenteral fluid intake. M a i n t e n a n c e - g r o u p infants received 3 to 4 mEq of sodium per kilogram per day; restricted infants received no sodium supplement other than with such treatments as transfusion. Sodium b a l a n c e studies c o n d u c t e d for 5 days demonstrated that m a i n t e n a n c e salt intake resulted in a daily sodium b a l a n c e near zero, whereas sodium-restricted infants c o n t i n u e d to e x c r e t e urinary sodium at a high rate, which p r o m o t e d a more n e g a t i v e b a l a n c e ( a v e r a g e daily sodium b a l a n c e - 0 . 3 0 _+ 1.78 SD in m a i n t e n a n c e group vs -3.71 _+ 1.47 mEq/kg per d a y in restriction group; p
