practical guidelines on fluid therapy pdf

Humidity for Premature Neonates clinical practice guidelineįoetal urine flow steadily increases with gestational age reaching 25 – 50 mL/hr at term and dropping to 8 – 16mL/hr (1-3mL/kg/hr) at birth reflecting the large exchange of TBW during foetal life and the abrupt change occurring with cardiopulmonary adaption after birth.

Phototherapy may increase IWL and therefore fluid intake may need to be increased by 10 – 20 ml/kg/dayįor Neonatal Jaundice clinical practice guideline.

An important variable influencing IWL is the maturity of neonate skin, with greater IWL in preterm babies resulting from evaporation through the Insensible water loss occurs via the skin and mucous membrane (two thirds) and respiratory tract (one third). To this gradual reduction with gestational age is a more abrupt reduction of TBW that occurs approximately 48 to 72 hours after birth which is closely related to the cardiopulmonary adaption.

Total body water (TBW) distribution gradually changes with increasing gestational age of the foetus, from the extreme preterm with TBW constituting 90% of body weight, to the term neonate with 75% TBW. Very Preterm A neonate born between 28 and 31+6 weeks of completed gestationĮxtremely Preterm A neonate born before 28 weeks of completed gestation Assessmentįluid balance is a function of the distribution of water in the body, water intake and water losses. Preterm A neonate born between 32 and 36+6 weeks of completed gestation Preterm A neonate born before 37 weeks of completed gestation Term A neonate born after 37 weeks of completed gestation

Neonate A neonate less than 28 days of age To maintain adequate hydration, fluid and sodium balance in the neonate admitted to the Butterfly Ward neonatal intensive care unit (NICU) or high dependency unit (HDU). Please refer to the Neonatologist on duty or PIPER service for specific advice. In addition, consideration needs to be given to the unwell term or preterm neonate as the disease pathophysiology may significantly influence fluid and electrolyte requirements.įluid management in the preterm neonate is specific and challenging due to increases in insensible water loss, reduced renal function and low birth weight. Therefore, appropriate management of fluid and electrolytes must take into consideration the birth weight, gestational age andĬorrected age. At birth, there is an excess ofĮxtracellular fluid which decreases over the first few days after birth extracellular fluid and insensible water losses increase as weight and gestational age decrease. The fluid and electrolyte requirements of the neonate are unique due to fluids shifts within the first few days and weeks of life. Disorders of fluid and electrolyte imbalance are amongst the most common disorders encountered in unwell neonates (both term and preterm).

Practical guidelines on fluid therapy pdf