Please, I need a protocol for treatment of neonatal hypernatremia ..

Hi! I'd say it depends on who the patient is. We sometimes see relatively well term infants who may suffer from hypertonic dehydration due to lack of established breastfeeding - those cases usually resolve with enteral feeding (by breast of bottle).

I guess you refer to typically preterm infants that commonly get hypernatremic due to negative water balance.

I can recommend this post on eMedicine : http://emedicine.medscape.com/article/976386-overview

The trick to avoid hypernatremia the first few days in life is regular checkups (electrolyte balance, urine output etc) and tailoring fluid administration from those.

 

 

thank you very much!

i had a 25+weeks preterm infant, Wt 900g，he was 14 days!,he need HFO, he had edema,but the urine output was normal,about 3-4ml/kg/h，he was resuscitated for  cardiac arrest in a week.now he has hypernatreamia，about 160-166.his fluid was 100-120ml/kg.d.so what can i do? thank you!

@lipinghuang I'd aim for sodium-free fluids iv, and an increased total volume/24h than you have, aiming at a normalization of S-Na over 36-48 hours. The edema is extravasal fluid, suggesting capillary leakage - there is a risk the edema only will increase with increasing total water administration. But a 14 days old infant could be given more fluid than 100-120 ml/kg/d, we are usually at 160-180 ml/kg/d at that age.