Use of Sterile Water Feeds for Treatment of Hypernatremia in Extremely Low Birth Weight Infants
| Status: | Completed |
|---|---|
| Conditions: | Obesity Weight Loss, Women's Studies |
| Therapuetic Areas: | Endocrinology, Reproductive |
| Healthy: | No |
| Age Range: | Any |
| Updated: | 2/4/2013 |
| Start Date: | November 2010 |
| End Date: | August 2011 |
| Contact: | Amy Bieda, PhD(c), RN |
| Email: | alb24@case.edu |
| Phone: | 216-368-4591 |
The Use of Enteral Sterile Water Feeds for the Treatment of Hypernatremia in Extremely Low Birth Weight Infants
The improved survival rate of extremely low birth weight(ELBW)infants has resulted in new
fluid and electrolyte problems that have not been encountered previously,in particular
electrolyte imbalance. ELBW infants are especially vulnerable to hypernatremia(serum sodium
value >150 mEq/L). Hypernatremia may be due to rapid dehydration or excessive administration
of intravenous fluids(IV)that contain sodium. The current treatment modality for
hypernatremia is to increase IV fluids above daily requirements.Enteral sterile water
feeds(ESWF)are theorized as an endogenous source of fluids that may decrease elevated
electrolytes such as sodium and potassium in premature infants. By giving ESWF to decrease
elevated electrolytes, there would be less need for large volumes of IVF that contribute to
the co-morbidities of prematurity: bronchopulmonary dysplasia (BPD),intraventricular
hemorrhage(IVH)and patent ductus arteriosus(PDA).
The purpose of this proposed study is to determine whether enteral sterile water feedings is
effective in decreasing the incidence, duration and severity of hypernatremia in ELBW
infants.
Inclusion Criteria:
- Infants less than or equal to 1,100 grams birth weight
- Less than or equal to 28 weeks gestational age
Exclusion Criteria:
- * Congenital heart disease, other than a PDA
- Major congenital anomalies
- A surgical condition (gastroschisis,omphalocele)
- Renal disease
- Hypotension treated with pressor support
- Reverse end diastolic flow on Doppler study prior to delivery
- Emergency medication received in the delivery room,except fluid boluses
- Apgar scores recorded at 10 minutes of life < or up to 5 and/or pH less than 7.0
on the first blood gas upon admission to the NICU
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