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September 1990

Serum Sodium Concentration and Intraventricular Hemorrhage in Premature Infants

Author Affiliations

From the Divisions of Neonatology (Drs Lupton and Whitfield) and Neurology (Drs Roland and Hill), Department of Pediatrics, University of British Columbia, British Columbia's Children's Hospital, Vancouver, Canada.

Am J Dis Child. 1990;144(9):1019-1021. doi:10.1001/archpedi.1990.02150330079026

• 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 (χ2=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.

(AJDC. 1990;144:1019-1021)

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