Boehm G, Handrick W, Spencker F B, Beyreiss K
Padiatr Padol. 1987;22(2):149-55.
In 14 premature infants suffering from bacterial sepsis during the first week of life the daily renal sodium and potassium losses as well as the concentrations in serum of both electrolytes were measured before and during the period of infection. 24 hours before appearance of first clinical symptoms of sepsis the sodium concentration in urine increases and the balance becomes negative. Hyponatraemia occurs later and is in correlation with the clinical course of the disease. Thus, the hyponatraemia is caused more by shifting of sodium from the extracellular space than by renal sodium excretion. To prevent this hyponatraemia the sodium intake has to be increased to 6 mmol/kg X 24 h as a minimum and the fluid intake has to be decreased to 80 ml/kg X 24 h as a maximum in the same time when antibiotic treatment is started. A short-term control of serum electrolytes is an important premise for a sufficient treatment. Increased sodium concentrations in urine of more than 50 mmol/l or again increasing concentrations beyond the second day of life can be appreciated as early signs of neonatal sepsis.
在14例出生后第一周患细菌性败血症的早产儿中，在感染期之前及期间测量了每日肾脏钠和钾的丢失量以及两种电解质的血清浓度。在败血症首次临床症状出现前24小时，尿钠浓度升高且平衡变为负值。低钠血症随后出现，并与疾病的临床进程相关。因此，低钠血症更多是由钠从细胞外间隙转移引起的，而非肾脏排钠所致。为预防这种低钠血症，在开始抗生素治疗的同时，钠摄入量必须至少增加至6 mmol/kg×24小时，液体摄入量必须最多减少至80 ml/kg×24小时。血清电解质的短期监测是充分治疗的重要前提。尿钠浓度超过50 mmol/l或出生第二天后浓度再次升高，可视为新生儿败血症的早期迹象。
