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Fluid management considerations in extremely preterm infants born at 22-24 weeks of gestation
Journal article   Open access   Peer reviewed

Fluid management considerations in extremely preterm infants born at 22-24 weeks of gestation

Johan Ågren, Jeffrey L Segar, Fanny Söderström and Edward F Bell
Seminars in perinatology, Vol.46(1), pp.151541-151541
02/2022
DOI: 10.1016/j.semperi.2021.151541
PMID: 34848064
url
https://doi.org/10.1016/j.semperi.2021.151541View
Published (Version of record) Open Access

Abstract

Emerging data regarding the encouraging outcomes of extremely preterm infants from centers taking active approaches to the care of these infants have prompted dialogue regarding optimal medical management. Among the multitude of decisions providers make in caring for extremely premature infants is the prescribing of parenteral fluids. Surprisingly, there are limited data to guide evidenced-based approaches to fluid and electrolyte management in this population. Immaturity of renal function and skin barriers contribute to the impaired capacity of the preterm infant to maintain salt and water homeostasis. This perspective paper highlights developmental physiological properties of the kidney and skin, which the provider needs to understand to provide parenteral fluid therapy. Additionally, we provide recommendations for initial fluid and electrolyte management of the preterm infant based on novel data as well as the published literature.
Electrolytes Female Gestational Age Humans Infant Infant, Extremely Premature Infant, Newborn Parenteral Nutrition Pregnancy

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