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International Journal of Pediatrics
Volume 2012, Article ID 931597, 7 pages
Clinical Study

Chloride Balance in Preterm Infants during the First Week of Life

1Neonatology and NICU, GHSR, CHR, BP 350, 97448 Saint Pierre Cedex, Réunion, France
2Centre d’Etudes Périnatales de l’Océan Indien, Centre d’Investigation Clinique et d’Epidémiologie Clinique (CIC-EC) CHR, 97410 Saint Pierre, Réunion, France
3Department of Neonatology, AP-HP, Groupe Hospitalier Cochin-Saint-Vincent de Paul, 75014 Paris, France
4Paris Descartes University, 75270 Paris, France
5NICU, Department of Paediatrics, University of Dijon, 21034 Dijon Cedex, France

Received 21 November 2011; Revised 15 December 2011; Accepted 15 December 2011

Academic Editor: Alan Richard Spitzer

Copyright © 2012 Silvia Iacobelli et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Objective. To describe the chloride balance in infants born 25–32-week gestation, analyze the association of chloride changes with hydroelectrolytic status and their relationship with perinatal conditions, morbidities, and neurological outcome. Methods. For 7 days after birth, sodium and chloride balance, plasma potassium, phosphate, and total carbon dioxide (tCO2) were prospectively determined and strong ion difference (SID) calculated. Three multivariate regression analyses were performed to identify factors associated with high plasma chloride concentration, low SID, and low tCO2. Results. 107 infants were studied. Plasma chloride concentration was significantly positively associated with plasma sodium concentration. Higher plasma chloride and lower SID were significantly associated with lower plasma tCO2. Chloride intake was the main independent factor associated with high plasma chloride, low SID, and low plasma tCO2, with lesser contribution of sodium intake and low gestational age (GA). Also, patent ductus arteriosus and birth weight loss were independent factors affecting plasma chloride and SID. Neither high chloride levels nor low SID were associated to impaired neurological outcome. Conclusions. In preterm infants, chloride balance is influenced by GA and by interrelationship between sodium and chloride intake. High chloride levels are associated with metabolic acidosis but not related to increased risk of impaired neurological outcome.