Aim: To investigate the effect of the therapeutic hypothermia (TH), used in infants with moderate or severe hypoxic-ischaemic encephalopathy (HIE), on fluid balance and incidence of hyponatremia.
Methods: Retrospective cohort study of moderate and severe HIE infants before (pre) and after (post) TH implementation. Daily fluid and electrolytes intake/output were collected from the medical records of each patient from day 1 to day 4 of life. Hyponatremia was defined as sodium <130 mEq/L.
Results: A total of 67 infants were studied: pre-TH = 29 and post-TH = 38. Infants in the post-TH group had greater weight gain [140 g (62, 227) vs. 10 g (-100, 105) p < 0.001] and lower serum sodium (130.9 ± 4.5 mmol/L vs. 133.4 ± 5.7, p = 0.008). The incidence of hyponatremia increased from 48 to 76% (p = 0.02).
Conclusion: In our centre, the implementation of TH was followed by an increased fluid retention and higher incidence of hyponatremia. Centres adopting TH should have clear guidelines for fluid and electrolyte management.
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