Am J Perinatol 2018; 35(10): 994-1000
DOI: 10.1055/s-0038-1632366
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Physiological Approach to Sodium Supplementation in Preterm Infants

David E. Segar
1  Stead Family Department of Pediatrics, Carver College of Medicine, University of Iowa, Iowa City, Iowa
,
Elizabeth K. Segar
1  Stead Family Department of Pediatrics, Carver College of Medicine, University of Iowa, Iowa City, Iowa
,
Lyndsay A. Harshman
1  Stead Family Department of Pediatrics, Carver College of Medicine, University of Iowa, Iowa City, Iowa
,
John M. Dagle
1  Stead Family Department of Pediatrics, Carver College of Medicine, University of Iowa, Iowa City, Iowa
,
Susan J. Carlson
2  Department of Food and Nutritional Services, University of Iowa Stead Family Children's Hospital, Iowa City, Iowa
,
Jeffrey L. Segar
1  Stead Family Department of Pediatrics, Carver College of Medicine, University of Iowa, Iowa City, Iowa
› Author Affiliations
Further Information

Publication History

16 October 2017

12 January 2018

Publication Date:
27 February 2018 (online)

Abstract

Objective To implement and evaluate a clinical practice algorithm to identify preterm infants with sodium deficiency and guide sodium supplementation based on urine sodium concentrations.

Study Design Urine sodium concentration was measured in infants born at 260/7 to 296/7 weeks' gestation at 2-week intervals. Sodium supplementation was based on the urine sodium algorithm. Growth and respiratory outcomes in this cohort were compared with a matched cohort cared for in our neonatal intensive care unit prior to algorithm implementation (2014–2015 cohort).

Results Data were compared for 50 infants in the 2014–2015 cohort and 40 infants in the 2016 cohort. Urine sodium concentration met criteria for supplementation in 75% of the 2016 cohort infants within the first 4 weeks after birth. Average daily sodium intake was greater in the 2016 cohort compared with the 2014–2015 cohort (p < 0.05). Caloric, protein, and total fluid intakes were similar between cohorts. The change in weight Z-score between 2 and 8 weeks of age was significantly greater in the 2016 versus 2014–2015 cohort (0.32 ± 0.05 vs. –0.01 ± 0.08; p < 0.01). No impact on respiratory status at 28 days of age or 36 weeks of postmenstrual age was identified.

Conclusion Institution of a clinical practice algorithm to instruct clinicians on sodium supplementation in preterm infants may improve growth outcomes.