Terri Marin, Samuel H Dowell, Kristen Wright, Asifhusen Mansuri, Paul C Mann
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Late-onset hyponatremia (LOH) frequently affects premature infants 2 or more weeks of age due to inadequate sodium intake and excessive kidney loss. Late-onset hyponatremia typically occurs in infants who are physiologically stable and is defined as serum sodium of 132 mEq/L or less or between 133 and 135 mEq/L if receiving sodium supplementation. Recent evidence suggests that spot urine sodium levels may improve the recognition of LOH, as low levels of excreted urine reflect a total body sodium deficit and negative balance. Untreated LOH may result in poor somatic growth, neurodevelopmental delay, higher incidence of bronchopulmonary dysplasia, and more severe retinopathy of prematurity. The primary prevention of LOH is to maintain serum sodium between 135 and 145 mEq/L; however, there are currently no formal protocols guiding sodium supplementation. The purpose of this article is to present on overview of LOH pathophysiology and its effect on somatic growth, neurodevelopment outcomes, and other related sequelae. We further discuss general management strategies and describe a protocol for sodium supplementation that is presently undergoing an evaluation for effectiveness.
期刊介绍:
The Journal of Perinatal and Neonatal Nursing (JPNN) strives to advance the practice of evidence-based perinatal and neonatal nursing through peer-reviewed articles in a topic-oriented format. Each issue features scholarly manuscripts, continuing education options, and columns on expert opinions, legal and risk management, and education resources. The perinatal focus of JPNN centers around labor and delivery and intrapartum services specifically and overall perinatal services broadly. The neonatal focus emphasizes neonatal intensive care and includes the spectrum of neonatal and infant care outcomes. Featured articles for JPNN include evidence-based reviews, innovative clinical programs and projects, clinical updates and education and research-related articles appropriate for registered and advanced practice nurses.
The primary objective of The Journal of Perinatal & Neonatal Nursing is to provide practicing nurses with useful information on perinatal and neonatal nursing. Each issue is PEER REVIEWED and will feature one topic, to be covered in depth. JPNN is a refereed journal. All manuscripts submitted for publication are peer reviewed by a minimum of three members of the editorial board. Manuscripts are evaluated on the basis of accuracy and relevance of content, fit with the journal purpose and upcoming issue topics, and writing style. Both clinical and research manuscripts applicable to perinatal and neonatal care are welcomed.