{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,24]],"date-time":"2025-11-24T16:25:05Z","timestamp":1764001505243,"version":"3.44.0"},"reference-count":29,"publisher":"BMJ","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arch Dis Child Fetal Neonatal Ed"],"accepted":{"date-parts":[[2000,5,11]]},"published-print":{"date-parts":[[2000,9,1]]},"abstract":"<jats:sec>\n                  <jats:title>BACKGROUND<\/jats:title>\n                  <jats:p>Fluid restriction has been reported to improve survival of infants without chronic lung disease (CLD), but it remains unknown whether it reduces CLD in a population at high risk of CLD routinely exposed to antenatal steroids and postnatal surfactant without increasing other adverse outcomes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>AIM<\/jats:title>\n                  <jats:p>To investigate the impact of fluid restriction on the outcome of ventilated, very low birthweight infants.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>STUDY DESIGN<\/jats:title>\n                  <jats:p>A randomised trial of two fluid input levels in the perinatal period was performed. A total of 168 ventilated infants (median gestational age 27 weeks (range 23\u201333)) were randomly assigned to receive standard volumes of fluid (60 ml\/kg on day 1 progressing to 150 ml\/kg on day 7) or be restricted to about 80% of standard input.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Similar proportions of infants on the two regimens had CLD beyond 28 days (56%<jats:italic>v<\/jats:italic> 51%) and 36 weeks post conceptional age (26% <jats:italic>v<\/jats:italic> 25%), survived without oxygen dependency at 28 days (31% <jats:italic>v<\/jats:italic> 27%) and 36 weeks post conceptional age (58% <jats:italic>v<\/jats:italic> 52%), and developed acute renal failure. There were no statistically significant differences between other outcomes, except that fewer of the restricted group (19% <jats:italic>v<\/jats:italic> 43%) required postnatal steroids (p\u2009&lt;\u20090.01). In the trial population overall, duration of oxygen dependency related significantly to the colloid (p\u2009&lt;\u20090.01), but not crystalloid, input level; after adjustment for specified covariates, the hazard ratio was 1.07 (95% confidence interval 1.02 to 1.13).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>In ventilated, very low birthweight infants, fluid restriction in the perinatal period neither reduces CLD nor increases other adverse outcomes. Colloid infusion, however, is associated with increased duration of oxygen dependency.<\/jats:p>\n                  <jats:p>\n                     <jats:boxed-text position=\"float\">\n                        <jats:sec>\n                           <jats:title>Key messages<\/jats:title>\n                           <jats:list list-type=\"simple\">\n                              <jats:list-item>\n                                 <jats:p>High fluid volumes increase the likelihood of a PDA, a risk factor for CLD development<\/jats:p>\n                              <\/jats:list-item>\n                              <jats:list-item>\n                                 <jats:p>One of four previous randomised trials showed that fluid restriction improved outcome\u2014that is, a lower mortality in a relatively mature population<\/jats:p>\n                              <\/jats:list-item>\n                              <jats:list-item>\n                                 <jats:p>We now show in ventilated VLBW infants that fluid restriction in the perinatal period does not reduce CLD; colloid infusion, however, increases duration of oxygen dependency<\/jats:p>\n                              <\/jats:list-item>\n                           <\/jats:list>\n                        <\/jats:sec>\n                     <\/jats:boxed-text>\n                  <\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/fn.83.2.f91","type":"journal-article","created":{"date-parts":[[2002,7,27]],"date-time":"2002-07-27T06:40:22Z","timestamp":1027752022000},"page":"F91-F96","source":"Crossref","is-referenced-by-count":69,"title":["Randomised trial of fluid restriction in ventilated very low birthweight infants"],"prefix":"10.1136","volume":"83","author":[{"given":"V","family":"Kavvadia","sequence":"first","affiliation":[{"name":"aChildren Nationwide Regional Neonatal Intensive Care Centre, King's College Hospital, London SE5 9RS, UK, \n\nbDepartment of Public Health, King's College Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A","family":"Greenough","sequence":"additional","affiliation":[{"name":"aChildren Nationwide Regional Neonatal Intensive Care Centre, King's College Hospital, London SE5 9RS, UK, \n\nbDepartment of Public Health, King's College Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G","family":"Dimitriou","sequence":"additional","affiliation":[{"name":"aChildren Nationwide Regional Neonatal Intensive Care Centre, King's College Hospital, London SE5 9RS, UK, \n\nbDepartment of Public Health, King's College Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R","family":"Hooper","sequence":"additional","affiliation":[{"name":"aChildren Nationwide Regional Neonatal Intensive Care Centre, King's College Hospital, London SE5 9RS, UK, \n\nbDepartment of Public Health, King's College Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2000,9,1]]},"reference":[{"key":"2025090513485728000_83.2.F91.1","doi-asserted-by":"crossref","first-page":"598","DOI":"10.1056\/NEJM198003133021103","article-title":"Effect of fluid administration on the development of symptomatic patent ductus arteriosus and congestive heart failure in premature infants.","volume":"302","author":"Bell","year":"1980","journal-title":"N Engl J Med"},{"key":"2025090513485728000_83.2.F91.2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(95)70362-4"},{"key":"2025090513485728000_83.2.F91.3","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1111\/j.1651-2227.1992.tb12205.x","article-title":"Fluid restriction for preventing bronchopulmonary dysplasia? 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