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Fluid Intake in the First Week of Life and the Duration of Hemodynamically Significant Patent Ductus Arteriosus in Extremely Preterm InfantsTotal daily fluid intake in 1st week of life & duration of hsPDA
OBJECTIVE: To determine the association between daily fluid intake and the duration of hemodynamically significant patent ductus arteriosus (hsPDA). METHODS: This is a retrospective cohort study of extremely preterm infants (<29 weeks) admitted in the Neonatal Intensive Care Unit at the Advent Health for Children from January 2013 to March 2016, if hsPDA was diagnosed in 1st week of life and serial echocardiograms were available. Diagnosis of hsPDA was based on a scoring system and its duration was estimated from serial echocardiograms. Cohort was divided in two groups based on duration of hsPDA (<1week, group-A or >1 week, group-B). Daily fluid intake was categorized as prescribed and actual. Prescribed volume was ordered by clinicians based on birth weight, not including trophic feeds, IV boluses or transfusions etc. Actual intake was calculated by the electronic medical records based on daily weights and included all enteral or parenteral fluids. Multivariate analysis was performed to determine an association between total daily fluid intake over the first week of life and the duration of hsPDA. Two groups were compared to show the difference between prescribed and actual daily fluid intakes. RESULTS: We enrolled 50 infants in Group-A and 76 in Group-B. Infants in group-B were of significantly lower gestation, required prolonged ventilation & hospitalization. An association between higher fluid intake in the first 2 days of life and prolonged duration of hsPDA was confirmed by multivariate analysis. Actual fluid intake was significantly higher than prescribed total fluid intake in first 4 days of life for infants in both groups. CONCLUSION: In extremely preterm infants, higher fluid intake in first 2 days of life is associated with prolonged duration of hsPDA. Actual daily fluid intake can be significantly higher than prescribed daily fluids due to daily weight changes and additional fluid administration.
Received: 08 August 2021
Accepted: 09 August 2021
12 August 2021 (online)
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