REVIEW article
Front. Pediatr.
Sec. Neonatology
Advancements in Research on Fluid Overload in Preterm Infants- -a narrative review
Provisionally accepted
- The Affiliated Hospital of Southwest Medical University, Luzhou, China
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Objective Fluid overload (FO) is a prevalent clinical challenge in preterm infants, contributing to multiorgan dysfunction and adverse outcomes. This review synthesizes the pathophysiology, clinical implications, and management strategies of FO to advance fluid management in preterm neonates. Methods We reviewed literature to define FO criteria, delineate its mechanisms (e.g., renal immaturity, endothelial glycocalyx impairment), and analyze associations with systemic complications. Current monitoring technologies and therapeutic interventions were evaluated. As a narrative review, literature identification and data extraction were conducted based on the research question and inclusion criteria without adhering to formal systematic review guidelines. All original studies cited in this review reported obtaining approval from institutional ethics committees and informed consent from parents or guardians. As a secondary analysis of published literature, this study does not involve new patient data and therefore required no additional ethical approval. Results FO pathogenesis involves underdeveloped renal function, compromised skin barriers, glycocalyx damage, and hypoalbuminemia. FO can lead to multisystem adverse outcomes. Noninvasive monitoring—echocardiography, bioelectrical impedance analysis (BIA), and lung ultrasound—demonstrates high clinical utility. Effective management includes strict fluid restriction, diuretic, and albumin infusion. Conclusion Optimizing FO management requires multimodal monitoring and individualized fluid regimens. Future research should prioritize refining assessment standards and developing targeted interventions to improve neonatal outcomes.
Keywords: Adverse outcome4, Fluid Overload1, Management of Fluids3, mechanisms5, Preterm Infant2
Received: 24 Aug 2025; Accepted: 11 Dec 2025.
Copyright: © 2025 Liu, Deng, Chen, Wan, Dong and Kang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Lan Kang
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