ABSTRACT
Urine output is adequate for a full-term stable prediuretic neonate. There is no hydrops, which can be seen in this condition and which usually complicates the fluid and electrolyte management. Resuscitation fluids choose the most appropriate initial resuscitation fluid for the clinical presentation given. Glucose in the initial resuscitation fluid is ill-advised because of the risk of hyperglycaemia and glycosuria. Colloids are unnecessary and relatively contraindicated. When the capillary membrane recovers this makes it more difficult to mobilise and excrete the excess fluid. Glucose is likely to induce hyperglycaemia. Occasionally, carcinoid syndrome-type flushing with impaired glucose tolerance is seen. Treatment is directed to correction of the water and the electrolyte abnormalities. Pharmacological suppression with somatostatin is helpful but the only cure is surgical resection, even if the residual tumour is benign. Neurological and encephalopathic symptoms are common. Severe metabolic acidosis with a wide anion gap is characteristic.
