Shaffer S G, Bradt S K, Hall R T
J Pediatr. 1986 Sep;109(3):509-14. doi: 10.1016/s0022-3476(86)80133-0.
Body water compartment changes were assessed during postnatal weight loss in 14 infants with respiratory distress syndrome. Total body water and extracellular volume were measured by dilution methods on the first day of life and again between the third and sixth days of life. Extracellular volume changes were calculated between the first and second determinations by measurement of chloride balance. Fluid therapy was prescribed to allow negative net water balance and a 1% to 3% reduction in body weight per day. All infants had concurrent reductions in body weight, total body water, and extracellular volume. Progressive daily extracellular volume reduction concurrent with weight loss was also apparent from chloride balance data. The correlation of changes in body weight with extracellular volume in individual subjects was poor (r = 0.05). We speculate that variations between sodium and free water balance in the sick preterm infant may be responsible for variability in the distribution of postnatal body water losses. Assessment of hydration in the newborn infant should include consideration of sodium balance and alterations of serum osmolality, and changes in body weight.
对14例呼吸窘迫综合征婴儿出生后体重减轻期间的体液分布变化进行了评估。在出生第一天以及出生后第三天至第六天期间，通过稀释法测量了总体液量和细胞外液量。通过测量氯平衡来计算第一次和第二次测定之间的细胞外液量变化。制定了液体疗法，以使净水平衡为负，且体重每天减轻1%至3%。所有婴儿的体重、总体液量和细胞外液量均同时减少。从氯平衡数据也可明显看出，随着体重减轻，细胞外液量每日逐渐减少。个体受试者体重变化与细胞外液量之间的相关性较差（r = 0.05）。我们推测，患病早产儿钠平衡和游离水平衡之间的差异可能是出生后体液丢失分布变化的原因。评估新生儿的水合状态应包括考虑钠平衡、血清渗透压改变以及体重变化。
