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.
Keywords
sodium - kidney - growth - premature infant - urine sodium
