Enteral water for hypernatremia and intestinal morbidity in infants less than or equal to 1000 g birth weight

Huston, Robert K.; Dietz, A; Campbell, Betty; Dolphin, Nancy; Sklar, R S; Wu, Yanqiu

doi:10.1038/sj.jp.7211622

Cited by 7 publications

(7 citation statements)

References 22 publications

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“…Parents need to be sufficiently informed about their child’s condition and treatment if they are to have confidence in the care their child is receiving and see their relationship to NICU staff as positive [5,10,12]. Parents who feel well-informed are satisfied with neonatal care [17,36] and feel involved in caring for their child [18,36,37]. …”

Section: Discussionmentioning

confidence: 99%

Strengths and weaknesses of parent–staff communication in the NICU: a survey assessment

2013

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BackgroundParents of infants hospitalized in the neonatal intensive care unit (NICU) find themselves in a situation of emotional strain. Communication in the NICU presents special challenges due to parental stress and the complexity of the highly technologized environment. Parents’ need for communication may not always be met by the NICU staff. This study aimed to describe strengths and weaknesses of parent–nurse and parent–doctor communication in a large level III NICU in Sweden in order to improve our understanding of parents’ communication needs.MethodsParents were asked to complete a survey consisting of sixteen questions about their experiences of communication with nurses and doctors in the NICU. In each question the parents evaluated some aspect of communication on a five- or six-point Likert scale. They also had the opportunity on each question to comment on their experiences in their own words. Data were analyzed using IBM SPSS Statistics 20.0 and qualitative manifest content analysis.Results270 parents (71.4%) completed the survey. Parents generally rated communication with the staff in the NICU positively and appreciated having received emotional support and regular information about their child´s care. Although a large majority of the parents were satisfied with their communication with doctors and nurses, only about half of the parents felt the nurses and doctors understood their emotional situation very well. Some parents would have desired easier access to conversations with doctors and wanted medical information to be given directly by doctors rather than by nurses. Parents’ communication with the staff was hampered when many different nurses were involved in caring for the infant or when the transfer of information in connection with shift changes or between the maternity ward and NICU was poor. Parents also desired to be present during doctors’ rounds on their infant.ConclusionsTraining both doctors and nurses in communication skills, especially in how to meet parents’ emotional needs better, could make communication at the NICU more effective and improve parental well-being. Creating a framework for the parents of what to expect from NICU communication might also be helpful. In addition, our results support the use of primary nurse teams to improve continuity of care and thereby promote successful communication.

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Section: Discussionmentioning

confidence: 99%

Strengths and weaknesses of parent–staff communication in the NICU: a survey assessment

2013

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“…This was not studied prospectively in critically ill adults. However, in premature infants in neonatal ICU the literature shows limited effect for treatment of hypernatremia with enteral free water and is associated with intestinal morbidity [21,22].…”

Section: Discussionmentioning

confidence: 99%

ICU acquired hypernatremia treated by enteral free water – A retrospective cohort study

Vos¹,

Voort

2021

Journal of Critical Care

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Purpose: ICU acquired hypernatremia (IAH) is associated with increased morbidity and mortality, however treatment remains controversial. This study aims to determine the effect of enteral free water suppletion in patients with IAH. Materials and methods: Retrospective single center study in a tertiary ICU. Inclusion criteria: patients with IAH and treatment with enteral free water. Exclusion criteria: patients with renal replacement therapy, diabetic ketoacidosis or hyperosmolar hyperglycaemic state. Primary outcome: change in plasma sodium (in mmol/l) after 5 days treatment. Responders were defined as patients with a decrease in sodium level of 5 mmol/l or more. Results: In total 382 consecutive patients were included. The median sodium level at the start of water therapy was 149 mmol/l (IQR 147-150). The median volume of enteral water was 4423 ml (IQR 3349-5379 ml) after 5 days and mean sodium decrease was 1.87 mmol/l (SD 4.84). There was no significant correlation between the volume of enteral water and sodium decrease (r 2 = 0.01). Conclusions: Treatment with enteral free water did not result in a clinically relevant decrease in serum sodium level in patients with IAH. In addition, the volume of enteral free water and the use of diuretics was unrelated with sodium change over 5 days.

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“…Debe tenerse cuidado de no usar agua estéril oral porque se ha asociado con enterocolitis y perforación intestinal en neonatos con hipernatremia. 34 En todos los neonatos con sodio sérico de 160 mEq/L o más, o en quienes haya contraindicación para la vía oral, se hará un cálculo de soluciones parenterales. El cálculo siguiente es válido para el neonato que aún mantiene diuresis (aunque haya oliguria).…”

Section: Tratamientounclassified

Tratamiento individualizado de la deshidratación hipernatrémica en el recién nacido

Candiani

2019

Acta Pediatr Mex

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La hipernatremia (sodio sérico 145 mEq/L) es un desequilibrio que, cuando es grave (160 mEq/L), puede causar alteraciones vasculares y neurológicas agudas, dejar secuelas graves o causar la muerte en recién nacidos.1-4 Se han descrito: trombosis del seno sagital superior,5-6 aórtica 7-8 mesentérica, renal, iliaca, femoral, poplítea7 y arteria retinal;9 hemorragia parenquimatosa,10 gangrena distal,7,11-12 enterocolitis necrosante,13 hipertensión arterial pulmonar e insuficiencia cardiaca derecha.14 La patogénesis de las lesiones cerebrales se describió hace más de medio siglo,15 muchas secundarias a una corrección inadecuada. Oddie16 informa una incidencia de 7 x cada 100,000 nacidos vivos. Se trata, en sí, de un trastorno de la concentración relativa de sodio en el espacio extracelular, y no necesariamente de la cantidad de sodio corporal total que puede estar elevada o ser normal; puede asociarse con volumen de agua corporal normal, alto o bajo.

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Enteral water for hypernatremia and intestinal morbidity in infants less than or equal to 1000 g birth weight

Cited by 7 publications

References 22 publications

Strengths and weaknesses of parent–staff communication in the NICU: a survey assessment

Strengths and weaknesses of parent–staff communication in the NICU: a survey assessment

ICU acquired hypernatremia treated by enteral free water – A retrospective cohort study

Tratamiento individualizado de la deshidratación hipernatrémica en el recién nacido

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