Does fluid restriction improve outcomes in infants with hypoxic ischemic encephalopathy? A pilot randomized controlled trial

J Perinatol. 2018 Nov;38(11):1512-1517. doi: 10.1038/s41372-018-0223-7. Epub 2018 Sep 11.

Abstract

Objective: To evaluate whether a strategy of restricted fluid intake in the first 4 days reduces mortality and morbidity among term neonates with moderate to severe hypoxic ischemic encephalopathy (HIE) treated with therapeutic hypothermia.

Study design: Eighty neonates with HIE were randomized between January 2016 and February 2018 to receive normal fluid intake (n = 40) or restricted fluid intake (two-third of normal intake; n = 40) in the first 4 days of life. The primary outcome was a composite of death or major neurodevelopmental disability at 6 months of age.

Results: The primary outcome occurred in 10 infants (26%) in the fluid-restricted group and 3 infants (8%) in the normal fluid intake group, but the difference was not statistically significant (p = 0.065). Five infants in the fluid-restricted group had hypoglycemia (p = 0.055).

Conclusion: Restricted fluid intake did not reduce the composite outcome of death or neurodevelopmental disability and was associated with a trend toward more hypoglycemia.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Asphyxia Neonatorum / complications*
  • Brain Edema / prevention & control
  • Female
  • Fluid Therapy*
  • Humans
  • Hypothermia, Induced
  • Hypoxia-Ischemia, Brain / etiology
  • Hypoxia-Ischemia, Brain / therapy*
  • India
  • Infant, Newborn
  • Male
  • Pilot Projects