Osmolality and oncotic pressure of volume expanding fluids for newborn administration

Resuscitation of the newborn frequently requires rapid expansion of the circulating volume and correction of metabolic acidosis and hypoglycemia. Solutions commonly used for resuscitation contain various concentrations of NaHCO3, glucose, electrolytes, and albumin. We have demonstrated the wide range of osmolalities of solutions frequently available in nurseries and delivery rooms and the resultant osmolalities caused by the addition of NaHCO3. We have also shown the in vitro concentration of albumin needed to equal full-term cord blood colloid osmotic pressure (COP).