Does restricted fluid administration can prevent Syndrome of Inappropriate ADH Secretion (SIADH) in neonate?

MM Hossain1, MAA Mamun2, M Shirin1, A Qader3, MNA Hasan2
Abstract

Background: With SIADH neonates are unable to excrete free water that is present
in intravenous (IV) fluids. This retained free water causes dilution of serum sodium,
and hyponatremia. Virtually any neonate requiring IV fluid is at risk of SIADH and
hyponatremia.
Objective: To optimize fluid and electrolyte support and precise guideline for fluid
therapy in neonate this study was designed to find out the relationship between fluid
administration and SIADH in sick neonate.
Methodology: This study was conducted in the Intensive Care Unit of Dhaka Shishu
Hospital from 1st June 2008 to 31st May 2009. All neonates admitted in Intensive
Care Unit during this period were included. Neonates were divided into two groups
one those who received standard fluid regimen and other those who received restricted
fluid regimen.
Result: Total 232 neonates were admitted with mean age 5.35±5.74 days, mean weight
2387.63±771.16 gm and mean gestational age 35.96±3.41 weeks. Among the admitted
neonates 134(57.8%) were male and 98(42.2%) were female with male female ratio
1.36:1. Among the neonates 131(56.5%) received IV fluid in restricted amount. Out of
this 15(6.5%) developed SIADH. Hundred one neonate received IV fluid which was
not restricted and out of them 19(8.2%) developed SIADH. No relation was found
between standard fluid administration and SIADH (χ2=2.471, df=1, p=0.08).
Conclusion: This study found that restricted fluid administration did not prevent
SIADH in neonate significantly. So unnecessary fluid restriction may be avoided in
neonate.
Key words Neonate, SIADH, Restricted Fluid

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