J Korean Soc Neonatol.  2004 Nov;11(2):113-121.

Fluid Therapy and Transfusion on Mechanical Ventilation

• Kim CS

Abstract

In newborn infants with mechanical ventilation in the first few days of life, fluid balance must be closely monitored because inadequate therapy related to overload may result in serious complications such as patent ductus arteriosus and pulmonary edema. Very low birth weight infants have significant change in body water balance in early neonatal period secondary to a large insensible water loss (IWL) and immaturity of renal function. Consequently these infants tend to have a high incidence of fluid overload so that fluid restriction with high humidification is effective during especially the first week of life. In infants with bronchopulmonary dysplasia, diuretics such as furosemide may act directly to improve lung mechanics by reabsorption of lung fluid, but chronic use may cause electrolyte imbalance, nephrocalcinosis and hearing deficit. In the early phase of perinatal asphyxia with oliguria, fluid restriction to amount equal to urine output and IWL is critical in order to prevent volume excess and potassium should not be given to avoid hyperkalemia. Blood components should always be infused through transfusion set with standard filter. To minimize adverse reactions of transfusion, basic rules must be observed. Moreover, storage of blood cells in small aliquots, using leukocyte removal filters and irradiation of blood can be helpful to prevent multiple donor exposure, cytomegalovirus infection, alloimmunization, and graft-versus-host rejection.

Keyword

Mechanical ventilation; Fluid restriction; Humidification; Leukocyte removal filter; Blood irradiation

MeSH Terms

Asphyxia
Blood Cells
Body Water
Bronchopulmonary Dysplasia
Cytomegalovirus Infections
Diuretics
Ductus Arteriosus, Patent
Fluid Therapy*
Furosemide
Hearing
Humans
Hyperkalemia
Incidence
Infant
Infant, Newborn
Infant, Very Low Birth Weight
Leukocytes
Lung
Mechanics
Nephrocalcinosis
Oliguria
Potassium
Pulmonary Edema
Respiration, Artificial*
Tissue Donors
Water Loss, Insensible
Water-Electrolyte Balance
Diuretics
Furosemide
Potassium