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Short report - Characterization of postnatal sodium fluctuations in very preterm neonates
Roland Gerull, Basel
Tuesday, Jan. 22, 2019 · 10:12 a.m. · 11m 30s
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i i i like to think i admit i mean you you give me the
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opportunity to talk about or a project on relational pasta so implications from
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and i was getting more and more interest in sodium and so did the asians whenever it occurs on the adults
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patience is especially for intensive care units because there's quite robust evidence
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that the swings of low sodium in five point five or opinion
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cause longer duration of authorisation costs um high risk of
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the admission higher cost and time ability and mythology
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furthermore there's some evidence that if you treat sodium individually
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and you try to others remain the sodium load in the uh
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normal range then you actually decrease mobility mentality in adults
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um i was wondering how this is indian names and then the judge is not that clear
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this um applications not yeah the data quality in general slow and um there are some
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h. m. publications saying that there's an increased risk of integrated i'm rich increase
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project development on it increased mortality with a type one fight you know
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we ah wanted to know what
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it's not a lot of literature out there saying what is norman in very low light infants
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and we aim to describe this serum sodium over the first
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twenty eight days of why very low but again that's
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and furthermore we'd like to identify risk factors or um that that influenza sodium
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we as i said uh oh what's that the gestation age the delivery mode
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small gestation age gender and initial zero it's both white and multiple
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we included patients from the insert without our um with interest actual age of less than thirty
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two weeks or a month and rams were born in the year two thousand seven forty
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overall one nine hundred and eighty patients we included in our final
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analysis eight hundred forty three patients that's a eighty six percent
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what they mean gestation age of twenty nine point one weeks than than me but would've twelve rounds
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overall we included almost twenty one thousand sodium measurements and we ended up
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an hour or we started out with the first lot we're really
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i'm just a lot of the individual sodium course over time which is seen in the graph
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and as you can imagine it's pretty difficult to get some meaningful data out of this crap
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also shows of bar
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we applied very complex a mathematical analysis and looting simulations and modelling and interest
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of time i'm not going to go to the to the notices
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on first we just um simply added the person file under the burden on
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the bottom we see that faith buttons either the fifty than that
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fifth percentile of the sodium over time and we see that the sodium
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at birth was round one hundred and thirty four miles per litter
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then um it started increasing not it is maybe he in
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here and not right about a little later on and
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point seven two days of life into sharp increase of court
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and uh the increase occurred until it because we just two
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point four days of white with the sodium increase to
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almost one hundred and forty three main supporter of that that we see a decline of the sodium again
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so we have an increase in the first days of light to of almost nine
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or a little more than nine minimal splitter transferring this data into adult literature
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um we know that adults would deprive of water suffer tremendously to get
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to increase of mine anymore splitter mortar in terms of concentration
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occupying all the statistic we resulted got some nice the grass that's shown here on the left
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side we see that the as mentioned before that the sodium does not rise right there
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beginning of life while at um two points as source well zero point seven
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two days of light and we see the graph on the left side
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right is that out of the gestation of nature we see in fact that the increased
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so dim that p. concentrations is correlated inversely with the gestation h. so on that
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twenty four when 'cause have the highest increased almost one hundred and forty five new remote for leaders and
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then we see and the other like grass that twenty six twenty eight thirty and thirty two years
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so we conclude what this um variable that gig is inversely correlated gestation h.
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we found what the variables that are associated with um changes in big so in concentration this is the
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do the remote we see that patients with that you know that we have higher sodium peaks
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on the right hand side i don't know if you can see from the back to see 'em they
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wrong minus the veteran over the very for twenty four weekends and four
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thirty two we 'cause and the bottom line is a c. section
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for twenty four week doesn't do we can so we see the effect of the the
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remote and we also does this see that effect of the um just patient age
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the third variable that is um are associated or that affects the sodium he gives the small registration
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page patience p. c. these patients have low was olympics and you can see them that often
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we have four parameters and not actually what's kind of both within multiple
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above did not effect the sodium concentrations of the so you pick
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we also interested in that time points but interest of time i will not go through the um lots on the right side
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but we can conclude that none of the seven they're adults had any
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effect on the fine points meaning that this in sodium increased that
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point seven two days of life at that time was it two point but he was a two point four days of work
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in summary in modelling and simulation along to correct or i
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saw him profiles with three parameters that influences sodium increase
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remote in the small water station page patients
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treatment with low gestation page invention of the livery had word price risk for extreme sodium
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um increase and um we just currently i'm
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trying to correlate the sodium fluctuation increase
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welcome but but don't have the results yet no present them in the next it's so thank you
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very much for your um attention and your time
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and and have a technique streets ha
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how much do you talk again question
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oh
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um in this study we did not we have a lot of information about that we discuss
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it just this week with our of statistics and from the phone call that unit
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and um we wanted to make and the like and model
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which paramedic going we influence in order to decrease the
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um sodium load for example giving more fluids for decrease
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oh my the one p. o. or whatever we can do and so
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there will be a model um developed to uh look across
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actually when we look at the literature there's one study from the express study which is a swedish sports study but of
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patients below twenty seven weeks this already um this
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asked this question if had some results that's
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or a little surprising and um maybe have some bias but this one um
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study for for example they say that the amount of fluids we get
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to the patients does not influence the sodium which sounds little
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question what's
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we did not have to not read it yet at the results it's no
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yes
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that's a very good question to be honest um i don't have a real
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good hypothesis because we say that patients who are born rationally have
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so to have a more mature then we should find the opposite
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and um
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we were thinking won't um maybe it's in effect of um adults around
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it should not be in fact of uh an
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uh_huh
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um it's just ah don't don't remember the name on
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well anyway we don't have that it's recognition for it
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well if this would be in the mountain
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factor then we should find the difference in baseline sodium
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concentration probably and we did not find it
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we we look at the baseline concentration this is this is um the same across all patients groups
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so there's not to no effect of the real live remote and the baseline sort of concentration
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actually
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well
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it depends what what is yeah
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how do we make this place it's a little difficult but what we can say what we expected that engine it just erodes
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should call some iteration should call sons tracks or the delivery mode
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cause stress for the patient
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but um we did not find trees these results to it i noticed us did not have an
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effect and to do the remove what patients um at the opposite effect that we expected
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because of the should on thank you very much for your dog
Conference Program
Welcome words
Matthias ROTH-KLEINER and Philipp MEYER, resp. Lausanne and Aarau
Jan. 22, 2019 · 9:34 a.m.
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Welcome words
Markus Hodel, Lucerne
Jan. 22, 2019 · 9:39 a.m.
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Short report - Outcome of very preterm infants
Philip Thwaites, Zürich
Jan. 22, 2019 · 9:42 a.m.
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Short report - Bronchopulmonary dysplasia (BPD)
Ikbel El Faleh, Lausanne
Jan. 22, 2019 · 9:50 a.m.
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Short report - Evaluation of exposure to vancomycin in neonates with current dosing approaches
Kim Dao, Lausanne
Jan. 22, 2019 · 10:01 a.m.
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Short report - Characterization of postnatal sodium fluctuations in very preterm neonates
Roland Gerull, Basel
Jan. 22, 2019 · 10:12 a.m.
Short report - Readiness for discharge in mothers of hospitalized neonates from a Swiss NICU: a study
Chloé Tenthorey, Lausanne
Jan. 22, 2019 · 10:24 a.m.
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Fetal diagnosis and therapy (part 1)
David Baud, Lausanne
Jan. 22, 2019 · 11:33 a.m.
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Fetal diagnosis and therapy (part 2)
Nicole Ochsenbein-Kölble, Zurich
Jan. 22, 2019 · 11:51 a.m.
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Minimal invasive therapy of congenital malformations
S. Holland-Cunz, Basel
Jan. 22, 2019 · 12:03 p.m.
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Discussion
Jan. 22, 2019 · 12:26 p.m.
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Management of PPROM around 34 weeks (part 1)
R. Pfister, Geneva
Jan. 22, 2019 · 2:48 p.m.
Management of PPROM around 34 weeks (part 2)
B. Martinez de Tejada, Geneva
Jan. 22, 2019 · 3:06 p.m.
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Late termination of pregnancy : legal, ethical and medical aspects
R. Favre, Strasbourg (France)
Jan. 22, 2019 · 3:58 p.m.
The beginning of life
T. Berger, Lucerne
Jan. 22, 2019 · 4:40 p.m.
480 views
Awards and Closing words
Jan. 22, 2019 · 5:04 p.m.
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