Somatic growth outcomes in response to an individualized neonatal sodium supplementation protocol.

IF 2.4 3区 医学 Q2 OBSTETRICS & GYNECOLOGY Journal of Perinatology Pub Date : 2024-10-17 DOI:10.1038/s41372-024-02141-9
Elliot J Stalter, Silvia L Verhofste, John M Dagle, Emily J Steinbach, Patrick Ten Eyck, Linder Wendt, Jeffrey L Segar, Lyndsay A Harshman
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Abstract

Objective: Evaluate the impact of a sodium (Na) supplementation protocol based upon urine Na concentration on growth parameters and morbidities.

Study design: Retrospective cohort study of infants 260/7-336/7 weeks gestational age (GA) cared for before (2012-15, n = 310) and after (2016-20, n = 382) implementation of the protocol. Within- and between-group changes over time were assessed using repeated measures generalized linear models.

Results: For infants 260/7-296/7 weeks GA, utilization of the protocol was associated with increased mean body weight z-score at 8-weeks postnatal age, increased mean head circumference z-score at 16-weeks postnatal age, and decreased time on mechanical ventilation (all p < 0.02). No impact on growth was identified for infants 30-336/7 weeks GA. Incidences of hypertension, hypernatremia, bronchopulmonary dysplasia, necrotizing enterocolitis, and culture positive sepsis were unaffected by the protocol.

Conclusion: Protocolized Na supplementation is associated with improved growth and reduced time on invasive mechanical ventilation in extremely preterm infants without increasing incidence of morbidities.

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个体化新生儿钠补充方案的体格生长结果。
目的:评估基于尿钠浓度的钠(Na)补充方案对生长参数和发病率的影响:评估基于尿液钠浓度的钠(Na)补充方案对生长参数和发病率的影响:研究设计:回顾性队列研究,对象为实施方案前(2012-15 年,n = 310)和实施方案后(2016-20 年,n = 382)的 260/7-336/7 周胎龄(GA)婴儿。使用重复测量广义线性模型评估了组内和组间随时间的变化:结果:对于出生后 260/7-296/7 周的婴儿,使用该方案与出生后 8 周平均体重 Z 值增加、出生后 16 周平均头围 Z 值增加和机械通气时间减少有关(所有 P 均为出生后 6/7 周)。高血压、高钠血症、支气管肺发育不良、坏死性小肠结肠炎和培养阳性败血症的发生率不受方案影响:结论:按方案补充 Na 可改善极早产儿的生长发育并缩短其接受侵入性机械通气的时间,同时不会增加发病率。
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来源期刊
Journal of Perinatology
Journal of Perinatology 医学-妇产科学
CiteScore
5.40
自引率
6.90%
发文量
284
审稿时长
3-8 weeks
期刊介绍: The Journal of Perinatology provides members of the perinatal/neonatal healthcare team with original information pertinent to improving maternal/fetal and neonatal care. We publish peer-reviewed clinical research articles, state-of-the art reviews, comments, quality improvement reports, and letters to the editor. Articles published in the Journal of Perinatology embrace the full scope of the specialty, including clinical, professional, political, administrative and educational aspects. The Journal also explores legal and ethical issues, neonatal technology and product development. The Journal’s audience includes all those that participate in perinatal/neonatal care, including, but not limited to neonatologists, perinatologists, perinatal epidemiologists, pediatricians and pediatric subspecialists, surgeons, neonatal and perinatal nurses, respiratory therapists, pharmacists, social workers, dieticians, speech and hearing experts, other allied health professionals, as well as subspecialists who participate in patient care including radiologists, laboratory medicine and pathologists.
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