Hi  I’d like to know your protocol to use Parenteral fluids ( volume) the first 3 day  in preterms < 32 weeks and for Term  infants 

we are employing 60-80 ml/k/day first day of solution of D10% with amino acids 

thanks 

Danielirra

 

We usually start at 60-80 ml/kg/day on the first day for moderate/late preterm and full-term, and a little higher at 80-100 ml/kg/day for very preterm, and 100-140 ml/kg/day for extremely preterm newborns. Then we advance 10-20ml/kg each day on the following days. The glucose infusion rate is usually 3.5 to 4 mg/kg/minute or even lower for extremely preterm instead of 6 mg/kg/min due to a high percentage of significant hyperglycemia. So the volume of Dextrose 5% and 10% will be gauged accordingly. I am not sure whether a higher rate of glucose infusion with Insulin or a lower acceptable rate of glucose is better in terms of hyperglycemia among extremely preterm newborns.

We normally use Dextrose 10% within the first 3 days of life and start with

- 60ml/kg/d for full-term, AGA,
- 70 ml/kg/d for 1500-2500g birth weight,
- 80 ml/kg/d for 1000-1500g birth weight, abd
- 90-100 ml/kg/d for 500-1000g birth weight.

The fluid intake is then beeing increased every day by 10ml/kg/d.