Fluid balance in critically ill neonates - ways to improve it

Fluid balance is an essential element of intensive care in critically ill neonates. Fluid and electrolyte management is carried out by constant and precise assessment of total fluid intake and output, frequent laboratory monitoring and fluid balance documenting. Accurate continuous and controlled intravenous fluid and drug administration via infusion pumps is crucial. One of the greatest "costs" of fluid and electrolyte status monitoring in critically ill neonates is the volume of blood required for its achievement. A significant volume of blood is required for laboratory testing and increases the need for red blood cell transfusions. In our retrospective observational study we evaluated the fluid balance in 30 critically ill neonates admitted to a level III multidisciplinary neonatal and paediatric intensive care unit (ICU) at the University Medical Centre Ljubljana (UMCL), between September 2011 and January 2012. The information generated by this study provided a basis for the improvement of existing management of fluid balance in critically ill neonates.