Department of Clinical Sciences, Pediatrics, Umeå University, Umeå, Sweden.
Department of Food, Nutrition and Culinary Science, Umeå University, Umeå, Sweden.
Acta Paediatr. 2022 Sep;111(9):1701-1708. doi: 10.1111/apa.16423. Epub 2022 Jun 10.
The aim of this study was to investigate the associations between sodium supply, fluid volume, sodium imbalances and severe intraventricular haemorrhage (IVH) in extremely preterm (EPT) infants.
We used data from the EXtremely PREterm infants in Sweden Study (EXPRESS) cohort consisting of all infants born at 22 to 26 gestational weeks from 2004 to 2007 and conducted a nested case-control study. For every infant with severe IVH (grade 3 or peri-ventricular haemorrhagic infarction), one IVH-free control infant with the birthday closest to the case infant and matched for hospital, sex, gestational age and birth weight was selected (n = 70 case-control pairs).
Total sodium supply and fluid volume were higher in infants with severe IVH compared with controls [daily total sodium supply until postnatal Day 2: mean ± SD (mmol/kg/day): 5.49 ± 2.53 vs. 3.95 ± 1.91, p = 0.009]. These differences were accounted for by sodium and fluid from transfused blood products. High plasma sodium concentrations or large sodium fluctuations were not associated with severe IVH.
Our results suggest a relationship between sodium-rich transfusions of blood products and severe IVH in EPT infants. It is unclear whether this is an effect of sodium load, volume load or some other transfusion-related factor.
本研究旨在探讨极低出生体重儿（EPT）的钠供应、液体量、钠平衡与严重脑室出血（IVH）之间的关系。
我们使用了 2004 年至 2007 年期间在瑞典 EXTremely PREterm infants in Sweden 研究（EXPRESS）队列中所有出生于 22 至 26 孕周的婴儿的数据，并进行了一项巢式病例对照研究。对于每一例严重 IVH（等级 3 或脑室周围出血性梗死）婴儿，选择一名 IVH 无出血且生日最接近病例婴儿、并与医院、性别、胎龄和出生体重相匹配的 IVH 无出血对照婴儿（n=70 对病例对照）。
与对照组相比，严重 IVH 婴儿的总钠供应和液体量更高[生后第 2 天的日总钠供应量：平均±标准差（mmol/kg/天）：5.49±2.53 与 3.95±1.91，p=0.009]。这些差异是由输注的血液制品中的钠和液体引起的。高血浆钠浓度或钠波动较大与严重 IVH 无关。
我们的结果表明，EPT 婴儿中富含钠的血液制品输注与严重 IVH 之间存在关系。目前尚不清楚这是钠负荷、容量负荷还是其他与输血相关的因素所致。
