Arch. Dis. Child

HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS REGISTER
[Advanced]

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this link to a friend
Right arrow Similar articles in ADC Online
Right arrow Similar articles in PubMed
Right arrow Add article to my folders
Right arrow Download to citation manager
Right arrowRequest Permissions
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Kavvadia, V
Right arrow Articles by Hooper, R
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Kavvadia, V
Right arrow Articles by Hooper, R
Arch Dis Child Fetal Neonatal Ed 2000;83:F91-F96 ( September )

Randomised trial of fluid restriction in ventilated very low birthweight infants

V Kavvadiaa, A Greenougha, G Dimitrioua, R Hooperb

a Children Nationwide Regional Neonatal Intensive Care Centre, King's College Hospital, London SE5 9RS, UK, b Department of Public Health, King's College Hospital

Correspondence to: Professor Greenough email: anne.greenough{at}kcl.ac.uk

Accepted 11 May 2000

BACKGROUND---Fluid restriction has been reported to improve survival of infants without chronic lung disease (CLD), but it remains unknown whether it reduces CLD in a population at high risk of CLD routinely exposed to antenatal steroids and postnatal surfactant without increasing other adverse outcomes.
AIM---To investigate the impact of fluid restriction on the outcome of ventilated, very low birthweight infants.
STUDY DESIGN---A randomised trial of two fluid input levels in the perinatal period was performed. A total of 168 ventilated infants (median gestational age 27 weeks (range 23-33)) were randomly assigned to receive standard volumes of fluid (60 ml/kg on day 1 progressing to 150 ml/kg on day 7) or be restricted to about 80% of standard input.
RESULTS---Similar proportions of infants on the two regimens had CLD beyond 28 days (56% v 51%) and 36 weeks post conceptional age (26% v 25%), survived without oxygen dependency at 28 days (31% v 27%) and 36 weeks post conceptional age (58% v 52%), and developed acute renal failure. There were no statistically significant differences between other outcomes, except that fewer of the restricted group (19% v 43%) required postnatal steroids (p < 0.01). In the trial population overall, duration of oxygen dependency related significantly to the colloid (p < 0.01), but not crystalloid, input level; after adjustment for specified covariates, the hazard ratio was 1.07 (95% confidence interval 1.02 to 1.13).
CONCLUSIONS---In ventilated, very low birthweight infants, fluid restriction in the perinatal period neither reduces CLD nor increases other adverse outcomes. Colloid infusion, however, is associated with increased duration of oxygen dependency.


Key messages

  • High fluid volumes increase the likelihood of a PDA, a risk factor for CLD development
  • One of four previous randomised trials showed that fluid restriction improved outcome---that is, a lower mortality in a relatively mature population
  • We now show in ventilated VLBW infants that fluid restriction in the perinatal period does not reduce CLD; colloid infusion, however, increases duration of oxygen dependency




Keywords: chronic lung disease; prematurity; very low birthweight; fluid restriction; lungs; survival


© 2000 by Archives of Disease in Childhood






HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS REGISTER
ARCH DIS CHILD FETAL NEONATAL ED ED PRACTICE
Terms and conditions relating to subscriptions purchased online  ¦  Website terms and conditions  ¦  Privacy policy
Copyright © 2000 BMJ Publishing Group Ltd & Royal College of Paediatrics and Child Health