Abstract
The ELBW neonate (< 1,000 grams) manifests large transepidermal water losses (100–200 mL/kg/day) at birth [1,2]. There is little skin keratin content, and the epidermis appears transparent and gelatinous. Also, these infants have a large volume of extracellular fluid [3,5] exposed to evaporate body water leaving sodium and potassium behind [4,5]. As much as 85% of body mass is water in the ELBW infant, the majority residing in the extracellular fluid compartment. Mature body water composition (60% of body mass) reverses this proportion with the majority of water volume residing in the intracellular space excluded from evaporative water loss. Moreover, the ELBW neonate has a relatively larger skin surface area exposed for evaporation from the extracellular compartment [6]. Compared to an adult, the ELBW baby proportionally has over 6 times the skin surface area exposed per unit mass of body water [5,6].
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