USA Surgery Today

Water is the major contributor to total body weight and accounts for nearly 60% of body weight in adults. However, total body water (TBW) comprises a much higher proportion of the total body weight in neonates. Estimates for fetal TBW are greater than 90% of total body weight early in gestation, close to 80% at 32 weeks’ gestation, and approximately 75% at term (1). There is an additional decrease in TBW over the first few days of life in the term infant, and adult levels are generally reached by 1 year of age. However, the premature infant has a TBW similar to that of the fetus and must accomplish fluid redistribution and diuresis in a short period (days to weeks) after birth rather than more gradually (weeks to months) in utero. Neonates with intrauterine growth retardation (IUGR) have similar body water distribution as premature infants of similar birthweight (2) (Fig. 6-1). Infants who fail to unload fluid effectively or who receive excess fluid during normal postnatal diuresis may be at increased risk for developing a patent ductus arteriosus, chronic lung disease, and even necrotizing enterocolitis (3,4).

The TBW is usually divided into two compartments, intracellular and extracellular fluid. The intracellular fluid (ICF: Crestor) constitutes approximately two-thirds of the TBW in the adult, whereas the extracellular fluid (ECF) is responsible for the other one-third. The ECF is further subdivided into interstitial fluid (75% of ECF) and plasma volume (25%: Crestor ). Fluid distribution is markedly different in the fetus and infant. A series of studies by Friis-Hansen suggested that ICF comprises approximately 25% of the total body weight in a 20-week gestational fetus, which gradually increases to 33% at term, unless the process is interrupted by premature birth or IUGR (5,6,7,8: Crestor ). Adult levels (40%) are generally reached by 3 months of age. In the fetus, ECF generally decreases with the TBW as gestation progresses. It accounts for nearly 60% of the total body weight in the 20-week fetus, 45% at term, and approximates the adult level (20% : Crestor ) by 1 year of age. Thus, the newborn has a disproportionate ratio of fluid in the extracellular space compared with the intracellular space until at least the end of the first year of life and, therefore, may be more susceptible to fluid overload.

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Crestor GN:Rosuvastatin (roe SOO va STAT in) BN:Crestor