Purpose: Extremely-low-birth-weight infants (ELBWIs), especially those 24 gestational weeks (GW), presented extremes in IWL and changes of water balance. The purpose of the present study was to retrospectively investigate fluid and electrolyte balance in infants of 24-GW during the first postnatal week under high humidification. Methods: Medical records of extremely-low-birth-weight infants (ELBWIs) who were born and admitted to the Neonatal Intensive Care Unit at Samsung Medical Center during March 2004-September 2010 were reviewed. Fluid intake, urine output, insensible water loss (IWL) and electrolyte balance of 22-GW (n=14), 23-GW (n=40) and 24-GW (n=67) infants nursed in high humidity (95%) were compared with 26-GW (n=65) infants nursed in 60% humidity Results: Survival rate until discharge was 33%, 82%, 75% and 89.3% in 22-GW, 23-GW, 24-GW and 26-GW infants, respectively. Compared to 26-GW infants, fluid intake and IWL was higher in 22-GW and 23-WG, but not as different in 24-GW. At postnatal day (P) 3-5, urine output was significantly lower in 26-GW infants than in the other age groups. Serum sodium level was significantly higher in 22-, 23-and 24-GW (P1-2) than in 26-GW infants. Hypernatremia (>150 mEq/dl sodium) was more frequent in 22-GW (71%), 23-GW (41%) and 24-GW (21%) than in 26-GW infants (14%). Conclusion: High-humidity environments significantly decreased fluid intake and improved electrolyte imbalance in 24-GW, but not in 22-and 23-GW infants. Increased IWL in the latter might be related to more immature skin, implicating the need for additional nurturing conditions.
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Sung et al. (2013) studied this question.