Actual electrolyte intake during the first week of life and morbidity in very-low-birthweight infants

Aim: To describe sodium and potassium intake, their sources and plasma concentrations, and the association between intake and morbidity in very-low-birthweight (VLBW, <1500 g) infants during the first week of life. Methods: This retrospective cohort study comprised 951 VLBW infants born at <32 weeks. Infants were divided into three groups according to gestational age: 23–26 (n = 275), 27–29 (n = 433) and 30–31 (n = 243) weeks. Data on fluid management and laboratory findings were acquired from an electronic patient information system. Results: The median sodium intake was highest in the 23–26 week group, peaking at 6.4 mmol/kg/day. A significant proportion of sodium derived from intravascular flushes; it reached 27% on day 1 in the 23–26 week group. High cumulative sodium intake in the first postnatal week was associated with weight gain from birth to day 8 in the 23–26 week group. High intake of sodium associated with an increased risk of surgically ligated patent ductus arteriosus (PDA), bronchopulmonary dysplasia and intraventricular haemorrhage, whereas low intake of potassium associated with an increased risk of PDA. Conclusion: Sodium intake in the most premature infants exceeded recommendations during the first postnatal week. Saline flushes accounted for a significant proportion of the sodium load.