All issues > Volume 50(6); 2007

Original Article

Korean J Pediatr. 2007;50(6):536-542. Published online June 15, 2007.

The effect of restricted fluid intakes in the first week of life on the risk of bronchopulmonary dysplasia and patent ductus arteriosus in very low birth weight infants

Hoe Kyoung HK Koo¹, Eun Na EN Choi¹, Ran R Namgung¹, Min Soo MS Park¹, Kook In KI Park¹, Chul C Lee¹

¹Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea

Correspondence Ran R Namgung ,Email: ranng@yumc.yonsei.ac.kr

Abstract

Purpose
: We investigated the effects of restricted fluid in the first 7 days of life on the risk of bronchopulmonary dysplasia (BPD) or patent ductus arteriosus (PDA) in very low birth weight (VLBW) infants.
Methods
: Eighty three VLBW infants who lived more than 28 days were selected. The amount of daily maintenance fluid was determined by calculation of insensible water loss (IWL) and urine output (UO). Seventy to 80 percent of calculated amount was given to the ventilated infants. Subjects were grouped into low (<25th%), moderate (25-75th%), and high (>75th%) fluid groups for the first 24 hours, 3 days and 7 days. Chi square tests analyzed proportions of subjects with or without morbidities across fluid groups. Multivariate logistic regression was used to analyze the effect of fluid intake on BPD or PDA, controlling for factors that are significantly associated with BPD or PDA by univariate analysis.
Results
: Rates of BPD and PDA were not significantly associated with fluid groups on each time period. The result was the same after controlling for factors that are significantly associated with BPD or PDA by univariate analysis. For the first 3 and 7 days, fluid intakes were positively related with maximal weight loss, urine output and mechanical ventilation duration.
Conclusion
: In VLBW infants, when given based on needs reflected from IWL and UO versus intake, relatively low fluid intakes in the first week of life do not decrease the risk of BPD or PDA, and vice versa. We suggest that calculation of daily fluid based on IWL and UO is appropriate for VLBW infants.

Keywords :Very low birth weight, Fluid therapy, Bronchopulmonary dysplasia, Patent ductus arteriosus