Impact of urine osmolality/urine sodium on the timing of diuretic phase and non-invasive ventilation support: Differences from late preterm to term neonates

Background: Extracellular fluid retained in the lungs lead to respiratory distress in both late preterm (LP) and term neonates. The relationship between urine parameters toward the diuresis and the duration of ventilation postnatally is unknown. To find the correlation between the diuretic phase wit...

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Main Authors: Yu-Hsuan Chien, Yi-Ling Chen, Li-Yi Tsai, Shu-Chi Mu
Format: Article
Language:English
Published: Elsevier 2020-02-01
Series:Pediatrics and Neonatology
Online Access:http://www.sciencedirect.com/science/article/pii/S1875957218305370
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author Yu-Hsuan Chien
Yi-Ling Chen
Li-Yi Tsai
Shu-Chi Mu
author_facet Yu-Hsuan Chien
Yi-Ling Chen
Li-Yi Tsai
Shu-Chi Mu
author_sort Yu-Hsuan Chien
collection DOAJ
description Background: Extracellular fluid retained in the lungs lead to respiratory distress in both late preterm (LP) and term neonates. The relationship between urine parameters toward the diuresis and the duration of ventilation postnatally is unknown. To find the correlation between the diuretic phase with urine parameters in the first 4 days after birth and the duration of non-invasive ventilation (NIV). Methods: Serial measurements of urine osmolality (Uosm), urine sodium (UNa), and urine output (U/O) in neonates were collected at 5 time periods (T1:0–12 postnatal hours, T2:12–24 postnatal hours, T3:24–48 postnatal hours, T4:48–72 postnatal hours, T5:72–96 postnatal hours) were recorded. The correlations were analyzed in late preterm and term neonates. Results: Ninety-seven neonates were included. Negative correlation between Uosm and U/O were observed. LP neonates (n=26) and term neonates (n=71) had differences with Uosm at T2, UNa at T4, T5, and U/O at T2, T3. Factors of U/O < 1 ml/kg/hr at T1 (odds ratio (OR) = 20.0; 95% confidence interval (CI) 1.796-222.776; p = 0.015) or Uosm > 273 mOsm/L at T1 (OR = 9.0; 95% CI 1.031-78.574; p = 0.047) in LP neonates and UNa > 26.5 mEq/L at T5 (OR = 23.625; 95% CI 2.683-79.276; p < 0.01) in term neonates were associated with prolonged NIV use (> 120 hours). Conclusion: We speculate the significant correlation between Uosm/UNa and the diuretic phase. The LP neonates acquire earlier diuretic phase than the term neonates. The Uosm/UNa in the first few postnatal days had the correlation with the duration of NIV support. Keywords: Diuretic phase, Neonate, Non-invasive ventilation, Urine osmolality, Urine sodium
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spelling doaj-art-b473c712ef7242fea1e6cd2766e4c09d2025-08-20T03:09:49ZengElsevierPediatrics and Neonatology1875-95722020-02-01611253010.1016/j.pedneo.2019.04.006Impact of urine osmolality/urine sodium on the timing of diuretic phase and non-invasive ventilation support: Differences from late preterm to term neonatesYu-Hsuan Chien0Yi-Ling Chen1Li-Yi Tsai2Shu-Chi Mu3Department of Pediatrics, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, TaiwanDepartment of Pediatrics, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan; College of Medicine, Taipei Medical University, Taipei, TaiwanDepartment of Pediatrics, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan; College of Public Health, Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University, Taipei, TaiwanDepartment of Pediatrics, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan; College of Medicine, Fu Jen Catholic University, Taipei, Taiwan; Corresponding author. Department of Pediatrics, No. 95, Wenchang Rd., Shilin Dist., Taipei City, 111, Taiwan, ROC. Fax: +886 2 28389335.Background: Extracellular fluid retained in the lungs lead to respiratory distress in both late preterm (LP) and term neonates. The relationship between urine parameters toward the diuresis and the duration of ventilation postnatally is unknown. To find the correlation between the diuretic phase with urine parameters in the first 4 days after birth and the duration of non-invasive ventilation (NIV). Methods: Serial measurements of urine osmolality (Uosm), urine sodium (UNa), and urine output (U/O) in neonates were collected at 5 time periods (T1:0–12 postnatal hours, T2:12–24 postnatal hours, T3:24–48 postnatal hours, T4:48–72 postnatal hours, T5:72–96 postnatal hours) were recorded. The correlations were analyzed in late preterm and term neonates. Results: Ninety-seven neonates were included. Negative correlation between Uosm and U/O were observed. LP neonates (n=26) and term neonates (n=71) had differences with Uosm at T2, UNa at T4, T5, and U/O at T2, T3. Factors of U/O < 1 ml/kg/hr at T1 (odds ratio (OR) = 20.0; 95% confidence interval (CI) 1.796-222.776; p = 0.015) or Uosm > 273 mOsm/L at T1 (OR = 9.0; 95% CI 1.031-78.574; p = 0.047) in LP neonates and UNa > 26.5 mEq/L at T5 (OR = 23.625; 95% CI 2.683-79.276; p < 0.01) in term neonates were associated with prolonged NIV use (> 120 hours). Conclusion: We speculate the significant correlation between Uosm/UNa and the diuretic phase. The LP neonates acquire earlier diuretic phase than the term neonates. The Uosm/UNa in the first few postnatal days had the correlation with the duration of NIV support. Keywords: Diuretic phase, Neonate, Non-invasive ventilation, Urine osmolality, Urine sodiumhttp://www.sciencedirect.com/science/article/pii/S1875957218305370
spellingShingle Yu-Hsuan Chien
Yi-Ling Chen
Li-Yi Tsai
Shu-Chi Mu
Impact of urine osmolality/urine sodium on the timing of diuretic phase and non-invasive ventilation support: Differences from late preterm to term neonates
Pediatrics and Neonatology
title Impact of urine osmolality/urine sodium on the timing of diuretic phase and non-invasive ventilation support: Differences from late preterm to term neonates
title_full Impact of urine osmolality/urine sodium on the timing of diuretic phase and non-invasive ventilation support: Differences from late preterm to term neonates
title_fullStr Impact of urine osmolality/urine sodium on the timing of diuretic phase and non-invasive ventilation support: Differences from late preterm to term neonates
title_full_unstemmed Impact of urine osmolality/urine sodium on the timing of diuretic phase and non-invasive ventilation support: Differences from late preterm to term neonates
title_short Impact of urine osmolality/urine sodium on the timing of diuretic phase and non-invasive ventilation support: Differences from late preterm to term neonates
title_sort impact of urine osmolality urine sodium on the timing of diuretic phase and non invasive ventilation support differences from late preterm to term neonates
url http://www.sciencedirect.com/science/article/pii/S1875957218305370
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