Nurses are usually the first staff member to pick up on symptoms of fluid overload such as a change in vitals or decrease in urine output. She comments that in clinical practice, both physician neonatologists and bedside nurses must be extremely attentive to prevent fluid overload by strict, accurate calculations of input and output. Excess fluid administration in the very low birth weight infant is often associated with congestive heart failure, intraventricular brain hemorrhage (bleeding in the brain) and bronchopulmonary dysplasia (chronic irritation and inflammation in the lungs). Mince also noted that excess fluid administration in the near term and term infants result in generalized edema, also called third spacing of fluid and abnormalities in pulmonary (lung) function.

The health care practitioner must take the infant’s birth weight, gestational age, and corrected age into consideration when determining the appropriate amount and rate of the fluid and/or blood infusion.” “Fluid administration in the very low birth weight infant can be challenging due to insensible water loss and renal function. Jaime Mince, RN, who specializes in Neonatal Intensive Care, notes that fluid and electrolyte imbalances are one of the most common causes of disorders among neonates in the NICU. Infants, children, expectant mothers, the elderly and patients with numerous comorbid health conditions are at the highest risk for serious adverse consequences with fluid overload. The NPUSA nursing staff has encountered iatrogenic fluid overload ( iatrogenic refers to illness caused by medical examination or treatment) in both clinical practice and case review across a wide spectrum of patients. Excessive intravenous fluid administration can cause electrolyte balances collections of fluid in the lungs and around the heart which can develop into pneumonia, respiratory distress, acute kidney injury and even heart failure. Inappropriate administration of intravenous fluids and/or blood infusion - either the incorrect volume (too much or too little), the incorrect type of fluid, or an accelerated rate of infusion- is a significant cause of patient morbidity and mortality. Intravenous fluid therapy and blood administration remain a fundamental part of hospital patient care. Medical Malpractice Primer: Hospital Induced Fluid Overload HOSPITAL INDUCED FLUID OVERLOAD: A POTENTIALLY DEADLY COMPLICATION THAT OFTEN GOES UNRECOGNIZED IN MEDICAL MALPRACTICE CASES

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