Usefulness of the fluid balance: A randomised controlled trial in neonates

Abstract

Aim To assess the effects of fluid balance charts in neonates with moderate disease severity on duration of hospitalisation and medical interventions. Methods Randomised, controlled trial in a neonatal ward in a general teaching hospital in the Netherlands between June 2009 and March 2010. One hundred seventy neonates with moderate disease severity, requiring continuous monitoring of vital parameters (mean gestational age 36+2 weeks (standard deviation 2+5 days), mean birthweight 2782 g (standard deviation 749 g)) participated. In the control group (n = 86), attending physicians could access all fluid balance data, whilst these data were blacked out in the intervention group (n = 84). Primary outcome was length of hospital stay. Secondary outcomes were percentage weight loss, interventions based on the fluid status, unblinding of fluid balance data and incident reporting. Results Length of hospital stay did not differ significantly between the intervention and the control group (median 9 vs. 8 days, with ratio of geometric mean 1.25, 95% confidence interval 0.99 to 1.57; P = 0.06). We found no significant differences in secondary outcomes. Conclusions Routinely keeping fluid balances in neonates with moderate disease severity does not affect duration of hospitalisation or medical treatment. © 2013 The Authors. Journal of Paediatrics and Child Health © 2013 Paediatrics and Child Health Division (Royal Australasian College of Physicians).