Professional Documents
Culture Documents
Management In
Newborns
fluid
ve sse
EXTRA CELLULAR fluid
INTRA CELLULAR fluid
cell interstitium
vessel
100
92% TBW……ECF…..ICF
77%
o d y W a t e r c o80n t e n t %
Fetus60% 66%
60% TBW
60
45%
42%
40 32% 36%
30% ICW
26%
ECW
20 N e w- 26%
B o r n
0
0 3 6 9 // 0
3 6 9
Age in months
Changes during delivery &
labour
• Urine
• stool (diarrhea and ostomy)
• naso/oro gastric drainage
• or any other loss .
Where does the water go ?
• INSENSIBLE
IN loses
means - UNmeasurable sources
Through…
• Skin
• Respiratory mucosa
•
In Sensible Water Loss(IWL)
• Key Variable.
• Shared: The skin- 2/3 + Respiratory
tract -1/3.
• IWL….inversely to…
1. Gestational Age (more preterm: more
IWL)
2. Postnatal age
Na
Na
Na Na
Na
How to reduce IWL
How to reduce IWL ?
1
2
20ml/kg for RW
= 240 ml intake
- 50 ml urine out put
-30 gm wt. gain
so total : 160 /3 = 53 ml / kg IWL
How to utilize IWL
measures?
Eg. 3 kg baby on day 2 : 200 ml
intake
53 ml / kg
IWL
GROWTH
Replacement
of Blood transfusions
loss IV Pushes
The Fluid Equation
Sensible
Insensible Water Loss Water Loss Growth
Stool
15-30ml /kg
Fluid requirements……VOLUME….
radiant warmer.
• Final total volume calculated for 24 hrs.
Restricted versus liberal water
intake
“ restriction of water intake so that
Changing Equations
Situation Recommendation
But I am tech
savy…!
• Insensible loss
üin Summers
üdue to inadequate feeding
üunder radiant warmer
üOpen body defects
• Sensible loss
ü in extreme prematures
ü diarrhoea
Hyper Natremia
Increasing Serum K+
• Acute Renal Failure
• Acidosis
• Cong.Adrenal Hyperplasia
• Intra ventricular Hemorrhage
• blood transfusion (>7 days stored)
membrane
excitability) § Kayexalate
§ IV calcium 1-2
§ Loop
cc/kg (10%)
l diuretic..Lasix
Internal § Peritoneal
Redistribution
§ IV insulin dialysis
glucose drip
§ IV NaHCO3
§ Exchange
Friends, Let’s Share our views….