Early Sodium Intake in Preterm Newborns

NCT ID: NCT04035564

Last Updated: 2020-04-21

Study Results

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

52 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-03-30

Study Completion Date

2020-03-20

Brief Summary

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Hyponatremia is a common complication among preterm infants, renal losses of sodium contribute to the development of hyponatremia in preterm newborns. Sodium imbalances impact in newborns outcome. There is controversy about the time of initiation and the requirements of sodium in premature infants. Hypothesis: early (24 hours of life) sodium supplementation (5mEq/kg/day) prevents the develop of hyponatremia in preterm infants.

Detailed Description

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This study is a randomized controlled trial in infants less than 35 weeks gestation admitted to the Newborn Intensive Care Unit at Children Hospital in Saltillo Coahuila Mexico.

Infants receive at 24 hours of life; sodium (5mEq/kg/day) versus less than 1mEq/kg/day. Weight, serum and urine sodium, serum chloride, serum and urine creatinine, serum chloride, bicarbonate and glucose are monitored daily during the first 3 days of life. Patients are assessed for hyponatremia, hypernatremia, weight change, sepsis, necrotizing enterocolitis and intraventricular hemorrhage.

Conditions

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Hyponatremia Premature

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

DOUBLE

Participants Caregivers

Study Groups

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Sodium < 1mEq/kg/day

Sodium administration enteral and/or parenteral less than 1mEq/kg/day started on day of life one

Group Type ACTIVE_COMPARATOR

Sodium < 1mEq/kg/day

Intervention Type DRUG

Sodium administration enteral and/or parenteral less than 1mEq/kg/day started on day of life 1

Sodium 5mEq/kg/day

Sodium administration enteral and/or parenteral 5mEq/kg/day started on day of life one

Group Type EXPERIMENTAL

Sodium 5mEq/kg/day

Intervention Type DRUG

Sodium administration enteral and/or parenteral 5mEq/kg/day started on day of life 1

Interventions

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Sodium < 1mEq/kg/day

Sodium administration enteral and/or parenteral less than 1mEq/kg/day started on day of life 1

Intervention Type DRUG

Sodium 5mEq/kg/day

Sodium administration enteral and/or parenteral 5mEq/kg/day started on day of life 1

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Preterm infants \<35 Weeks gestation

Exclusion Criteria

* Urinary malformations
* Congenital abdominal wall defect
* Intestinal atresia / obstruction
* Congenital heart defect
Maximum Eligible Age

24 Hours

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Hospital del Niño "Dr. Federico Gomez Santos"

OTHER

Sponsor Role lead

Responsible Party

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csanchezg

Pediatric Nephrology

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Carlos Sanchez, MD

Role: PRINCIPAL_INVESTIGATOR

Pediatric Nephrology

Ben D Valdes, MD

Role: PRINCIPAL_INVESTIGATOR

Neonatology

Locations

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Hospital del Niño Dr Federico Gomez Santos

Saltillo, Coahuila, Mexico

Site Status

Countries

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Mexico

References

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Wang J, Xu E, Xiao Y. Isotonic versus hypotonic maintenance IV fluids in hospitalized children: a meta-analysis. Pediatrics. 2014 Jan;133(1):105-13. doi: 10.1542/peds.2013-2041. Epub 2013 Dec 30.

Reference Type BACKGROUND
PMID: 24379232 (View on PubMed)

Bhatia J. Fluid and electrolyte management in the very low birth weight neonate. J Perinatol. 2006 May;26 Suppl 1:S19-21. doi: 10.1038/sj.jp.7211466.

Reference Type BACKGROUND
PMID: 16625217 (View on PubMed)

Moritz ML, Ayus JC. Hyponatremia in preterm neonates: not a benign condition. Pediatrics. 2009 Nov;124(5):e1014-6. doi: 10.1542/peds.2009-1869. Epub 2009 Oct 26. No abstract available.

Reference Type BACKGROUND
PMID: 19858147 (View on PubMed)

Balasubramanian K, Kumar P, Saini SS, Attri SV, Dutta S. Isotonic versus hypotonic fluid supplementation in term neonates with severe hyperbilirubinemia - a double-blind, randomized, controlled trial. Acta Paediatr. 2012 Mar;101(3):236-41. doi: 10.1111/j.1651-2227.2011.02508.x. Epub 2011 Nov 19.

Reference Type BACKGROUND
PMID: 22040311 (View on PubMed)

Al-Dahhan J, Haycock GB, Nichol B, Chantler C, Stimmler L. Sodium homeostasis in term and preterm neonates. III. Effect of salt supplementation. Arch Dis Child. 1984 Oct;59(10):945-50. doi: 10.1136/adc.59.10.945.

Reference Type BACKGROUND
PMID: 6497431 (View on PubMed)

Gawlowski Z, Aladangady N, Coen PG. Hypernatraemia in preterm infants born at less than 27 weeks gestation. J Paediatr Child Health. 2006 Dec;42(12):771-4. doi: 10.1111/j.1440-1754.2006.00975.x.

Reference Type BACKGROUND
PMID: 17096711 (View on PubMed)

Lonnqvist PA. III. Fluid management in association with neonatal surgery: even tiny guys need their salt. Br J Anaesth. 2014 Mar;112(3):404-6. doi: 10.1093/bja/aet436. Epub 2013 Dec 23. No abstract available.

Reference Type BACKGROUND
PMID: 24368557 (View on PubMed)

Oh W. Fluid and electrolyte management of very low birth weight infants. Pediatr Neonatol. 2012 Dec;53(6):329-33. doi: 10.1016/j.pedneo.2012.08.010. Epub 2012 Oct 12.

Reference Type BACKGROUND
PMID: 23276435 (View on PubMed)

Hartnoll G, Betremieux P, Modi N. Randomised controlled trial of postnatal sodium supplementation on oxygen dependency and body weight in 25-30 week gestational age infants. Arch Dis Child Fetal Neonatal Ed. 2000 Jan;82(1):F19-23. doi: 10.1136/fn.82.1.f19.

Reference Type BACKGROUND
PMID: 10634836 (View on PubMed)

Hartnoll G, Betremieux P, Modi N. Randomised controlled trial of postnatal sodium supplementation on body composition in 25 to 30 week gestational age infants. Arch Dis Child Fetal Neonatal Ed. 2000 Jan;82(1):F24-8. doi: 10.1136/fn.82.1.f24.

Reference Type BACKGROUND
PMID: 10634837 (View on PubMed)

Lorenz JM, Kleinman LI, Kotagal UR, Reller MD. Water balance in very low-birth-weight infants: relationship to water and sodium intake and effect on outcome. J Pediatr. 1982 Sep;101(3):423-32. doi: 10.1016/s0022-3476(82)80078-4.

Reference Type BACKGROUND
PMID: 7050331 (View on PubMed)

Costarino AT Jr, Gruskay JA, Corcoran L, Polin RA, Baumgart S. Sodium restriction versus daily maintenance replacement in very low birth weight premature neonates: a randomized, blind therapeutic trial. J Pediatr. 1992 Jan;120(1):99-106. doi: 10.1016/s0022-3476(05)80611-0.

Reference Type BACKGROUND
PMID: 1731034 (View on PubMed)

Koletzko B, Goulet O, Hunt J, Krohn K, Shamir R; Parenteral Nutrition Guidelines Working Group; European Society for Clinical Nutrition and Metabolism; European Society of Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN); European Society of Paediatric Research (ESPR). 1. Guidelines on Paediatric Parenteral Nutrition of the European Society of Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) and the European Society for Clinical Nutrition and Metabolism (ESPEN), Supported by the European Society of Paediatric Research (ESPR). J Pediatr Gastroenterol Nutr. 2005 Nov;41 Suppl 2:S1-87. doi: 10.1097/01.mpg.0000181841.07090.f4. No abstract available.

Reference Type BACKGROUND
PMID: 16254497 (View on PubMed)

Bolisetty S, Osborn D, Sinn J, Lui K; Australasian Neonatal Parenteral Nutrition Consensus Group. Standardised neonatal parenteral nutrition formulations - an Australasian group consensus 2012. BMC Pediatr. 2014 Feb 18;14:48. doi: 10.1186/1471-2431-14-48.

Reference Type BACKGROUND
PMID: 24548745 (View on PubMed)

Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Other Identifiers

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01/03/18N01

Identifier Type: -

Identifier Source: org_study_id

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