Abstract 111
Background: Early fluid restriction may reduce neonatal chronic lung disease, but potentially has side-effects. Intervention: In a randomized trial, we have compared the impact of two fluid regimes on the outcome of ventilated, very low birthweight infants. In fluid regime B infants were prescribed 60 ml/kg maintenance on day one increasing to 180 ml/kg on day 7 and in fluid regime A the infants were prescribed approximately 35% lower maintenance volumes. Throughout the perinatal period, episodes of hypoglycaemia, hypernatraemia, jaundice and hypotension were recorded. Creatinine was measured daily and arginine vasopressin (AVP) levels on days 1, 3 and 5. Subjects: 50 infants in each group, both with median gestational age 28 weeks (range 23-33); 36 in each group received antenatal steroids, 34 in Group A and 32 in Group B surfactant. Results: Overall infants were jaundiced on 212 of the 700 possible days; there were 109 episodes of hypoglycaemia, 118 of hypernatraemia and 107 of hypotension. Despite infants on regime A receiving significantly less fluid on each study day than those on regime B (p<0.001), the only significant difference between the groups was more infants on regime B were jaundiced on day 3 (p<0.04). In addition, no statistically significant differences were found between the two groups regarding creatinine or AVP levels on any study day. Conclusion: We conclude modest fluid restriction in the perinatal period is not associated with increased adverse effects.
