weekly question 20/7/2025

[Admin]

An otherwise healthy 38-week-gestation, three-kg newborn with gastroschisis undergoes bedside closure using an umbilical flap (i.e. sutureless closure). On the second day of life the baby is making adequate urine. Nasogastric tube output is 20 mL/kg/day. The current total fluid requirement per day for this infant following gastroschisis closure is

A 60 mL/kg

B 80 mL/kg

C 100 mL/kg

D 120 mL/kg

E 150 mL/kg

 

[Ismailmohamed]

E

 

[samar]

E :150 ml/kg/day

• baseline maintenance fluid: 80–100 mL/kg/day.
• Add NG output and insensible losses.

 

[Abd El wahed]

D

 

[Admin]

Correct answer
C 100 mL/kg

A normal term newborn weighing more than 2500 g requires 60 mL/kg/day on the first 24 hours of life, 80 mL/kg on the second day and 100 mL/kg on the third day of life. In this patient with gastroschisis, the nasogastric tube output should be accounted for in calculating the fluid losses. Thus, 80mL/kg maintenance (for DOL #2) + 20 mL/kg NG losses = 100 mL/kg/day. Fluid resuscitation and replacement in these infants should done carefully as fluid over replacement increases ventilation days, parenteral nutrition days, length of stay and risk of bacteremia.