In the October 2009 issue of Pediatrics, Baraton et al revealed that large variations in serum sodium (SNa) concentration in the very preterm neonate (<33 weeks' gestation) are an independent risk factor for poor neuromotor outcome at 2 years. A large variation in SNa concentration was, in fact, the most predictive risk factor for poor neuromotor outcome even after controlling for other known risk factors, which is likely related to the development of hyponatremia. The incidence of hyponatremia (SNa < 130 mEq/L) was 24%, whereas that of hypernatremia (SNa > 150 mEq/L) was <2%. Seventy-five percent of the infants with a variation in SNa concentration of >13 mEq/L had hyponatremia, with an average nadir SNa concentration of 126 mEq/L. Overcorrection of hyponatremia did not seem to be a factor for this group, because the change in SNa concentration averaged 6 mEq/L per day, with the variation in SNa...

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