Sweet or Salty: Comparing Dextrose and Sodium Acetate Umbilical Arterial Catheter Fluids.

OBJECTIVE: To evaluate safety and clinical benefit of sodium acetate umbilical arterial catheter (UAC) fluid in neonates. METHODS: This single-center, retrospective cohort study included neonates receiving dextrose 5% or sodium acetate 77 mEq/L heparinized fluid for UAC patency. The primary outcome was the potential number of capillary heel sticks avoided. Secondary outcomes included hypernatremia, intraventricular hemorrhage, metabolic acidosis, acute kidney injury, chronic lung disease, and parenteral nutrition optimization. Subgroup analysis was performed for patients undergoing therapeutic hypothermia and preterm infants. RESULTS: There were 202 patients (dextrose n = 100; sodium acetate n = 102) included. The sodium acetate group demonstrated a greater number of potential heel sticks avoided per UAC line day (0 vs 2.2; p < 0.001). Despite a higher incidence of hypernatremia (sodium > 145 mEq/L) with sodium acetate, hypernatremia with sodium > 150 mEq/L were not significant between groups and there were no significant differences in other clinical outcomes. CONCLUSIONS: Using sodium acetate for UAC patency is safe and may decrease the number of painful capillary heel sticks.