La Haye-Caty Noémie, Barbosa Vargas Stephanie, Maluorni Julie, Rampakakis Emmanouil, Zappitelli Michael, Wintermark Pia
Division of Newborn Medicine, Department of Pediatrics, McGill University, Montreal, Canada.
JSS Medical Research, Montreal, Canada.
J Matern Fetal Neonatal Med. 2020 Oct;33(20):3521-3528. doi: 10.1080/14767058.2019.1578747. Epub 2019 Feb 27.
To study the consequences of restricting fluid and sodium intake in asphyxiated newborns treated with hypothermia. We conducted a retrospective cohort study of asphyxiated newborns treated with hypothermia from 2009 to 2015. The fluid, parenteral nutrition, and sodium, as well as the urine produced per day, were calculated. Sodium and creatinine concentrations were recorded. The presence/severity of brain injury was scored. Among the 202 newborns, 55% did not have their fluid and sodium intake restricted and 45% had their fluid and sodium intake restricted. Newborns for whom fluid and sodium was restricted had significantly lower sodium concentrations during hospitalization ( = .02) and tended to develop more often a sodium concentration lower than 125 mmol/L ( = .08). They also were more likely to experience worsening in their creatinine levels during hospitalization ( = .03) and developed more often acute kidney injury ( = .02). The incidence of severe brain injury was higher in those newborns (58 versus 43%, = .12), although not statistically different. A restrictive strategy for fluid and sodium intake did not appear to be beneficial for asphyxiated newborns treated with hypothermia and might even be harmful.
研究低温治疗的窒息新生儿限制液体和钠摄入的后果。我们对2009年至2015年接受低温治疗的窒息新生儿进行了一项回顾性队列研究。计算了液体、肠外营养、钠以及每日产生的尿量。记录了钠和肌酐浓度。对脑损伤的存在/严重程度进行了评分。在202例新生儿中，55%的新生儿未限制液体和钠的摄入，45%的新生儿限制了液体和钠的摄入。限制液体和钠摄入的新生儿在住院期间钠浓度显著较低（P = 0.02），且更常出现钠浓度低于125 mmol/L的情况（P = 0.08）。他们在住院期间肌酐水平恶化的可能性也更大（P = 0.03），且更常发生急性肾损伤（P = 0.02）。这些新生儿中重度脑损伤的发生率较高（58%对43%，P = 0.12），尽管无统计学差异。对于接受低温治疗的窒息新生儿，限制液体和钠摄入的策略似乎并无益处，甚至可能有害。
