Somatic growth outcomes in response to an individualized neonatal sodium supplementation protocol

Research Square Pub Date : 2024-02-05 DOI:10.21203/rs.3.rs-3911085/v1

Lyndsay Harshman, Elliot Stalter, Silvia Verhofste, John Dagle, Emily Steinbach, P. Eyck, Linder Wendt, Jeffrey Segar

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Abstract

Abstract Objective Evaluate the impact of a sodium (Na) supplementation protocol based upon urine Na concentration on growth parameters and morbidities. Study Design Retrospective cohort study of infants 26 0/7 -33 6/7 weeks gestational age (GA) cared for before (2012-15, n = 225) and after (2016-20, n = 157) implementation of the protocol. Within- and between-group changes over time were assessed using repeated measures generalized linear models. Results For infants 26 0/7 -29 6/7 weeks GA, utilization of the protocol was associated with increased mean body weight z-score at 8-weeks postnatal age, increased mean head circumference z-score at 16-weeks postnatal age, and decreased time on mechanical ventilation (all p < 0.02). No impact on growth was identified for infants 30–33 6/7 weeks GA. Incidences of hypertension, hypernatremia, bronchopulmonary dysplasia, and culture positive sepsis were unaffected by the protocol. Conclusion Protocolized Na supplementation results in improved growth and reduced time on invasive mechanical ventilation in extremely preterm infants without increasing incidence of morbidities.

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个体化新生儿钠补充方案的体格生长结果

摘要目的评估基于尿液钠浓度的钠（Na）补充方案对生长参数和发病率的影响。研究设计对该方案实施前（2012-15 年，n = 225）和实施后（2016-20 年，n = 157）孕龄为 26 0/7 -33 6/7 周的婴儿进行回顾性队列研究。使用重复测量广义线性模型评估组内和组间随时间的变化。结果对于出生后 26 0/7 -29 6/7 周的婴儿，使用该方案与出生后 8 周平均体重 Z 值的增加、出生后 16 周平均头围 Z 值的增加以及机械通气时间的减少有关（均 p < 0.02）。对于出生后 30-33 6/7 周的婴儿，未发现对生长有任何影响。该方案对高血压、高钠血症、支气管肺发育不良和败血症培养阳性的发生率没有影响。结论对极度早产儿按方案补充钠可改善其生长发育并缩短其接受有创机械通气的时间，同时不会增加发病率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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