Neonatal fluid, electrolyte and nutritional management — case

Case summary

A 1000-gram male infant is born at 28 weeks' gestation to a 29-year-old primigravida after preterm labour. He is admitted to the neonatal unit and started on parenteral nutrition from birth. On day 2 of life he is on 80 mL/kg/day of parenteral fluid. His weight is now 6% below birthweight, his urine output is 3 mL/kg/h, and a routine electrolyte panel shows a potassium of 7.0 mmol/L with peaked T waves on the cardiac monitor. Sodium is 138 mmol/L, creatinine 96 µmol/L, and glucose 5.2 mmol/L on a glucose infusion rate of 6 mg/kg/min. He has not yet started enteral feeds. ^{[4] [2]}