Abstract
Background: Fluid balance monitoring is commonly used to assess patient fluid volume status. However, studies on its reliability and usefulness are lacking, particularly in newborns.
Aim: To assess clinical usefulness of recording fluid balances in sick neonates.
Methods: We conducted a randomised, controlled non-inferiority trial in newborns admitted to the high care ward in whom urine output and body weight were assessed daily. Fluid balance data and totals were available in the control group, but were blacked out in the intervention group, thus blinding the attending physician to this information. The primary outcome was hospitalization duration, secondary outcomes included interventions based on information from the fluid balance, and broken randomisation codes by the attending physicians.
Results: 170 neonates were included in the intention-to-treat analysis (mean gestational age 36 weeks 2 days, mean birth weight 2751 gram). Median hospitalization duration was 9 days in the intervention group (n=86) and 8 days in the control group (n=84) (95% CI of difference 0-3 days, p=0.18). No differences in medical interventions influencing fluid status, were reported. The code was broken once.
Conclusion: Recording fluid balance in neonatal high care does not reduce hospitalization duration or medical interventions. This time-consuming and inaccurate method cannot be recommended as a routine procedure in newborn high care.
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Van Asperen, Y., Brand, P. & Bekhof, J. 436 Utility of the Fluid Balance in Sick Neonates Admitted to the Neonatal High Care Ward. Pediatr Res 68 (Suppl 1), 224 (2010). https://doi.org/10.1203/00006450-201011001-00436
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DOI: https://doi.org/10.1203/00006450-201011001-00436
