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Am J Perinatol 2023; 40(12): 1345-1350
DOI: 10.1055/a-1585-6093
Original Article

Fluid Intake in the First Week of Life and the Duration of Hemodynamically Significant Patent Ductus Arteriosus in Extremely Preterm Infants

Hussnain Mirza
1   Center for Neonatal Care, University Central Florida College of Medicine, Advent Health for Children, Orlando, Florida
,
Jorge Garcia
2   Division of Pediatric Cardiology, Advent Health for Children, Orlando, Florida
,
Chelsea Bell
3   Clinical Nutrition Program, Advent Health for Children, Orlando, Florida
,
Kristen Jones
4   Pediatric Pharmacy Services, Advent Health for Children, Orlando, Florida
,
Vicki Flynn
5   Office of Pediatric Research Advancement and Support, Advent Health, Orlando, Florida
,
Julie Pepe
5   Office of Pediatric Research Advancement and Support, Advent Health, Orlando, Florida
,
William Oh
5   Office of Pediatric Research Advancement and Support, Advent Health, Orlando, Florida
› Author Affiliations Funding This study was supported by our internal funding provided by Advent Health for Children, Orlando, FL.
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Abstract

Objective This study aimed to determine the association between daily fluid intake and the duration of hemodynamically significant patent ductus arteriosus (hsPDA).

Study Design This is a retrospective cohort study of extremely preterm infants (<29 weeks) admitted in the Neonatal Intensive Care Unit of the Advent Health for Children from January 2013 to March 2016, if hsPDA was diagnosed in first week of life and serial echocardiograms were available. Diagnosis of hsPDA was based on a scoring system and its duration was estimated from serial echocardiograms. Cohort was divided into two groups based on duration of hsPDA (<1week, group A and ≥1 week, group B). Daily fluid intake was categorized as prescribed and actual. Prescribed volume was ordered by clinicians based on birth weight, not including trophic feeds, intravenous (IV) boluses or transfusions, etc. Actual intake was calculated by the electronic medical records based on daily weights and included all enteral or parenteral fluids. Multivariate analysis was performed to determine an association between total daily fluid intake over the first week of life and the duration of hsPDA. Two groups were compared to observe the difference between prescribed and actual daily fluid intakes.

Results We enrolled 50 infants in group A and 76 in group B. Infants in group B were of significantly lower gestation and required prolonged ventilation and hospitalization. An association between higher fluid intake in the first 2 days of life and prolonged duration of hsPDA was confirmed by multivariate analysis. Actual fluid intake was significantly higher than prescribed total fluid intake in first 4 days of life for infants in both groups.

Conclusion In extremely preterm infants, higher fluid intake in first 2 days of life is associated with prolonged duration of hsPDA. Actual daily fluid intake can be significantly higher than prescribed daily fluids due to daily weight changes and additional fluid administration.

Key Points

  • In preterm infants, actual daily fluid intake may be higher than prescribed volume.

  • Higher daily fluid intake in first week of life is associated with prolonged duration of PDA.

  • PDA scoring system can be helpful for objective assessment of PDA in preterm infants.

Keywords

PDA - extremely preterm infants - total daily fluid intake


Publication History

Received: 08 August 2021

Accepted: 09 August 2021

Accepted Manuscript online:
12 August 2021

Article published online:
23 November 2021

© 2021. Thieme. All rights reserved.

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