II. Physiology: Insensible Water Loss (IWL)

  1. Weight <1000 grams: 52 ml/kg/day
  2. Weight <1250 grams: 56 ml/kg/day
  3. Weight <1500 grams: 46 ml/kg/day
  4. Weight >1500 grams: 26 ml/kg/day

III. Physiology: Newborn Renal limits

  1. Limits are more severe in younger gestation
  2. Limited ability to concentrate or dilute urine
  3. Decreased Glomerular Filtration Rate
  4. Decreased renal blood flow
  5. Decreased resorption of Glucose, Sodium, bicarbonate
  6. Inability to excrete acid and phosphate load

IV. Physiology: Decreased fluid requirements

  1. Renal Failure or cardiac failure
  2. Lower insensible water loss
  3. High Anti-Diuretic hormone level

V. Physiology: Increased fluid requirements

  1. Excess Insensible water loss
  2. Fever
  3. High Activity
  4. High renal loss

VI. Indications: Parenteral nutrition (amino acids, lipids)

  1. Enteral intake <50 kcal/kg/day for >48 hours

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