Serum sodium concentration and intraventricular hemorrhage in premature infants
B. A. Lupton, E. H. Roland, M. F. Whitfield and A. Hill
Division of Neonatology, University of British Columbia, Vancouver, Canada.
Recent data suggest that early loss of brain tissue water content, ie,
decreased extravascular cerebral tissue pressure, may play a role in the
pathogenesis of germinal matrix/intraventricular hemorrhage in the
premature newborn. This study examines the relationship between the
concentration of serum sodium and germinal matrix/intraventricular
hemorrhage in 299 premature infants with birth weights of less than 1500 g
during the first 4 days of life. Intraventricular hemorrhage developed in
34 (32%) of the 106 infants with maximum serum sodium levels of 145 mmol/L
or less and in 54 (28%) of 193 infants whose highest serum sodium levels
were greater than 145 mmol/L (chi 2 = 0.37). These data suggest that
concentrations of serum sodium greater than 145 mmol/L are not associated
with an increased risk of germinal matrix/intraventricular hemorrhage in
the premature newborn. Consequently, more liberal administration of fluids
to maintain extravascular cerebral tissue pressure is unlikely to reduce
the incidence of germinal matrix hemorrhage/intraventricular hemorrhage.
