FEN

Neonatal Fluid Management

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Neonatal Fluid Management, Newborn Fluid Management

  • Physiology
  • Insensible Water Loss (IWL)
  1. Weight <1000 grams: 52 ml/kg/day
  2. Weight <1250 grams: 56 ml/kg/day
  3. Weight <1500 grams: 46 ml/kg/day
  4. Weight >1500 grams: 26 ml/kg/day
  • Physiology
  • Newborn Renal limits
  1. Limits are more severe in younger gestation
  2. Limited ability to concentrate or dilute urine
  3. Decreased Glomerular Filtration Rate
  4. Decreased renal blood flow
  5. Decreased resorption of Glucose, Sodium, bicarbonate
  6. Inability to excrete acid and phosphate load
  • Physiology
  • Decreased fluid requirements
  1. Renal Failure or cardiac failure
  2. Lower insensible water loss
  3. High Anti-Diuretic hormone level
  • Physiology
  • Increased fluid requirements
  1. Excess Insensible water loss
  2. Fever
  3. High Activity
  4. High renal loss
  • Indications
  • Parenteral nutrition (amino acids, lipids)
  1. Enteral intake <50 kcal/kg/day for >48 hours