RESPONSE OF THE NEWBORN INFANT TO MAJOR SURGERY

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Abstract
Balance data for sodium, potassium, chloride, nitrogen, and water were obtained postoperatively in 15 newborn infants operated upon in the first 4 days of life and in 5 control newborn infants. The infants showed a response in terms of electrolyte and water balances which is significantly different from that reported in adults: The volumes of urine were equal to or greater than those in normal infants of a comparable age. The data suggest a diminished capacity of the newborn to conserve water postoperatively, but a normal capacity to dilute the urine. No evidence of retention of water was observed. The urinary excretion of sodium and chloride was equal to or larger than that of normal infants. The infants who had losses postoperatively from gastrointestinal suction showed no capacity to reduce renal excretion of these ions while they suffered these large extrarenal losses. The concentrations of sodium and chloride in the serum remained normal or became slightly elevated postoperatively. Losses of potassium and nitrogen in the urine were of the same relative magnitude as those in adults. The observed responses are discussed in terms of the function of antidiuretic and adrenocortical hormones in the newborn infant. The application of these data to practical considerations of fluid and electrolyte therapy in the postoperative management of the newborn infant are discussed briefly.

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