Observational studyPediatric research2020
ELBW infants receive inadvertent sodium load above the recommended intake.
Observational study in Pediatric research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it, 13 citations in OpenAlex.
- Sodium supplementation strategies in preterm infants: effects on growth, electrolyte balance, and exploratory evidence on neurodevelopment - a systematic review and meta-analysis.BMC nutrition · 2026Pooled it
- The Changing Landscape of Sodium Needs in the Preterm Neonate for Optimizing Growth and Development.Nutrients · 2026Review
- Early glucose and sodium trajectories and short-term outcomes in extremely preterm infants.Frontiers in pediatrics · 2026Article
- Tiny baby math: supralinear implications for management of infants born at less than 24 weeks gestation.Journal of perinatology : official journal of the California Perinatal Association · 2025Article
- Sodium Patterns and Their Variables in a Cohort of ELBW Infants in the First 10 Days of Life.Children (Basel, Switzerland) · 2025Article
- Hypo- and Hypernatremia in Extremely Low Birth Weight Infants in the First 10 Days of Life: A Review.Children (Basel, Switzerland) · 2025Review
- Excessive sodium supplementation but not fluid load is correlated with overall morbidity in extremely low birth weight infants.JPGN reports · 2024Article
- Neurodevelopmental consequences of early plasma sodium changes in very preterm infants.Pediatric research · 2022Article
- Influence of early fluid overload on bronchopulmonary dysplasia in very low-birth-weight infants.Frontiers in pediatrics · 2022Article
- Optimising insulin aspart practices in a neonatal intensive care unit: a clinical and pharmaco-technical study.European journal of pediatrics · 2021Article
- Is inadvertent electrolyte overload in very preterm infants preventable?Pediatric research · 2020Article
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Authors and funding
8 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTo determine total sodium load, including inadvertent load, during the first 2 postnatal weeks, and its influence on serum sodium, morbidity, and mortality in extremely low birth weight (ELBW, birth weight <1000 g) infants and to calculate sodium replacement models.
methodsRetrospective data analysis on ELBW infants with a gestational age <28 + 0/7 weeks.
resultsNinety patients with a median birth weight of 718 g and a median gestational age of 24 + 6/7 weeks were included. Median sodium intake during the first 2 postnatal weeks was 10.2 mmol/kg/day, which was significantly higher than recommended (2-5 mmol/kg/day). Sodium intake did not affect the risk for hypernatremia. Each mmol of sodium intake during the first postnatal week was associated with an increased risk of bronchopulmonary dysplasia (45%) and higher-grade intraventricular hemorrhage (31%), during the second postnatal week for necrotizing enterocolitis (19%), and during both postnatal weeks of mortality (13%). Calculations of two sodium replacement models resulted in a decrease in sodium intake during the first postnatal week of 3.2 and 4.0 mmol/kg/day, respectively.
conclusionsSodium load during the first 2 postnatal weeks of ELBW infants was significantly higher than recommended owing to inadvertent sodium intake and was associated with a higher risk of subsequent morbidity and mortality, although the study design does not allow conclusions on causality. Replacement of 0.9% saline with alternative carrier solutions might reduce sodium intake. IMPACT: Sodium intake in ELBW infants during the first 2 postnatal weeks was twofold to threefold higher than recommended; this was mainly caused by inadvertent sodium components. High sodium intake is not related to severe hypernatremia but might be associated with a higher morbidity in terms of BPD, IVH, and NEC. Inadvertent sodium load can be reduced by replacing high sodium-containing carrier solutions with high levels of sodium with alternative hypotonic and/or balanced fluids, model based.
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