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Higher Parenteral Electrolyte Intakes in Preterm Infants During First Week of Life: Effects on Electrolyte Imbalances
Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
Umeå University, Faculty of Social Sciences, Department of Food, Nutrition and Culinary Science.ORCID iD: 0000-0002-4649-0653
Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.ORCID iD: 0000-0002-0726-7029
2022 (English)In: Journal of Pediatric Gastroenterology and Nutrition - JPGN, ISSN 0277-2116, E-ISSN 1536-4801, Vol. 75, no 3, p. E53-E59Article in journal (Refereed) Published
Abstract [en]

Objectives: This study aimed to investigate the effects of a higher intake of electrolytes from parenteral nutrition (PN) on plasma electrolyte concentrations in very low birth weight (VLBW, <1500 g) infants.

Methods: This was a single-center cohort study including all VLBW infants born before (n = 81) and after (n = 53) the implementation of a concentrated PN regimen. Daily nutritional intakes and plasma concentrations of sodium, chloride, potassium, phosphate, and calcium were collected from clinical charts.

Results: During the first postnatal week, electrolyte intakes were higher in infants who received concentrated PN compared with infants who received original PN. Infants who received concentrated PN had a lower incidence of hypokalemia (<3.5 mmol/L; 30% vs 76%, P < 0.001) and severe hypophosphatemia (<1.0 mmol/L; 2.2% vs 17%, P = 0.02). While the relatively high prevalence of severe hypophosphatemia in infants who received original PN can be explained by a phosphorus intake below the recommendation, the potassium intake during the first 3 postnatal days (mean ± SD: 0.7 ± 0.2 mmol/kg/d) was within the recommendation. The prevalence of early hypernatremia was not affected by the different sodium intake in the 2 groups.

Conclusions: In VLBW infants, a sodium-containing PN solution (about 2.7 mmol/100 mL) does not cause hypernatremia during the first days of life. Furthermore, providing at least 1 mmol potassium/kg/d during the first 3 postnatal days might be necessary to prevent early hypokalemia.

Place, publisher, year, edition, pages
Lippincott Williams & Wilkins, 2022. Vol. 75, no 3, p. E53-E59
Keywords [en]
chloride, hypernatremia, hypokalemia, potassium, preterm infants, sodium
National Category
Pediatrics Nutrition and Dietetics
Identifiers
URN: urn:nbn:se:umu:diva-199394DOI: 10.1097/MPG.0000000000003532ISI: 000841921200005PubMedID: 35726971Scopus ID: 2-s2.0-85137009137OAI: oai:DiVA.org:umu-199394DiVA, id: diva2:1699632
Available from: 2022-09-28 Created: 2022-09-28 Last updated: 2022-09-28Bibliographically approved

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Späth, CorneliaStoltz Sjöström, ElisabethDomellöf, Magnus

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