ALVEOLAR-ARTERIAL O2 AND CO2 DIFFERENCES AND THEIR RELATION TO LUNG VOLUME IN THE NEWBORN

PEDIATRICS ◽  
1968 ◽  
Vol 41 (3) ◽  
pp. 574-587 ◽  
Author(s):  
D. W. Thibeault ◽  
E. Poblete ◽  
P. A. M. Auld
Keyword(s):  
Carbon Dioxide ◽  
Premature Infants ◽  
Lung Volume ◽  
Term Infant ◽  
Full Term ◽  
Arterial Oxygen ◽  
Term Infants ◽  
Oxygen Gradient ◽  
Thoracic Gas Volume ◽  
Gas Volume

Twenty-six premature and five full-term infants, ranging in birth weight from 860 to 4,040 gm and in age from 3 hours to 98 days, were the subjects of this study. Measurements of thoracic gas volume and determination of alveolar-arterial oxygen gradient and arterial-alveolar carbon dioxide gradient were performed. All infants showed a decrease in thoracic gas volume in the first days of life. The initial high thoracic gas volume is thought to be due to trapped gas. The ability to trap gas was demonstrated in a number of infants. In the full-term infant the decrease in thoracic gas volume is associated with improvement in lung function. In the premature infants the decrease in lung volume is associated with a persistently elevated alveolar-arterial oxygen gradient and in an inequality of perfusion and ventilation, as evidenced by the large arterial-alveolar carbon dioxide gradient. In a small group of infants increase in functional residual capacity produced by negative pressure around the chest resulted in a decrease in the carbon dioxide and oxygen gradients, indicating that the infant's lung volume is less than optimum. These observations characterize in physiological terms some of the respiratory difficulties in small premature infants.

THORACIC GAS VOLUME CHANGES IN PREMATURE INFANTS

PEDIATRICS ◽  
1967 ◽  
Vol 40 (3) ◽  
pp. 403-411
Author(s):  
D. W. Thibeault ◽  
M. M. Wong ◽  
P. A. M. Auld
Keyword(s):  
Oxygen Tension ◽  
Premature Infants ◽  
Arterial Oxygen Tension ◽  
Full Term ◽  
Arterial Oxygen ◽  
Volume Changes ◽  
Term Infants ◽  
Thoracic Gas Volume ◽  
Gas Volume ◽  
Serial Measurements

Serial measurements of thoracic gas volume and arterial oxygen tension in a group of small premature infants are reported. The study demonstrated that when thoracic gas volume reached levels for normal, full-term infants arterial oxygen tension approached full-term values. The study indicates extensive pulmonary abnormality in clinically non-distressed premature infants, most likely due to persistent atelectasis or partially aerated alveoli. Observations suggest that the infant attempts to correct this abnormality by frequent periodic hyperinflations or sighs.

Round Table Discussion

PEDIATRICS ◽  
1951 ◽  
Vol 8 (3) ◽  
pp. 431-434
Author(s):  
HEYWORTH N. SANFORD ◽  
J. HAROLD ROOT ◽  
R. H. GRAHAM
Keyword(s):  
Premature Infant ◽  
Premature Infants ◽  
Death Rate ◽  
Round Table ◽  
Term Infant ◽  
Full Term ◽  
Round Table Discussion ◽  
Premature Births ◽  
Term Infants ◽  
Full Term Infant

Chairman Sanford: Dr. Herman N. Bundesen, Commissioner of Health of Chicago, organized 12 years ago the "Chicago Premature Plan." This consists in registering all premature infants with the City Health Department within a few hours after birth. The premature infant who is born at home, or in a hospital that does not have adequate premature care, is transported in an oxygenated incubator ambulance to a hospital which specializes in such care. From 1936 to 1947 premature infant deaths in Chicago have been lowered 6½%. The full term infant death rate during the same period has been lowered about 3%. Inasmuch as the premature death rate has been lowered about double that of the full term infant rate, we believe this procedure has been the cause of reduction. In 1936 there were 47,000 live births in Chicago. In 1947 there were 82,000, or an increase of 80%. In this number the full term infants increased from 45% to 60%, whereas the premature infants increased from 2000 to over 5000, or about 140% increase of premature infants born in Chicago during the last 10 years. This adds a considerable increase to the number of infants for our available premature infants beds. Where formerly we planned 5 premature births to each 100 full term births, we now find that prematures have increased to 8 per 100 full term infants. Causes of prematurity are multiple births, toxemia, heart disease, syphilis, tuberculosis, infections, accidents, premature separation of the placenta and abnormalities of the reproduction tract. It is generally understood that there is a tendency for more premature births among the Negro race than the white race.

CARBONIC ANHYDRASE IN THE PREMATURE

PEDIATRICS ◽  
1968 ◽  
Vol 42 (3) ◽  
pp. 429-436
Author(s):  
E. Poblete ◽  
D. W. Thibeault ◽  
P. A. M. Auld
Keyword(s):  
Carbon Dioxide ◽  
Carbonic Anhydrase ◽  
Premature Infants ◽  
Carbonic Anhydrase Activity ◽  
Full Term ◽  
Term Infants ◽  
Low Levels

Carbonic anhydrase activity was measured in the blood of premature and full-term infants to determine if the arterial-alveolar carbon dioxide gradient was related to low levels of carbonic anhydrase. The time at which levels in these infants approached the adult was studied as well. The study demonstrates that CO2 gradients do not correlate with blood carbonic anhydrase activity, and minimal or no activity can be associated with a small gradient. An increase in the carbonic anhydrase activity-produced by transfusion did not significantly change the CO2 gradient. Premature infants approach adult levels of activity in 6 to 7 months.

THE POSTNATAL DEVELOPMENT OF THE COAGULATION SYSTEM IN THE PREMATURE INFANT

1987 ◽  
Author(s):  
M Andrew ◽  
B A Paes ◽  
R A Milner ◽  
P J Powers ◽  
M Johnston ◽  
...  
Keyword(s):  
Premature Infant ◽  
Postnatal Development ◽  
Premature Infants ◽  
Reference Values ◽  
Gestational Age ◽  
Term Infant ◽  
Full Term ◽  
Screening Tests ◽  
Coagulation System ◽  
Term Infants

A cohort study was performed to determine the postnatal development of the coagulation system in the “healthy” premature infant. Mothers were approached for consent and a total of 132 premature infants were entered into the study. The group consisted of 64 infants with gestational ages of 34-36 weeks (prem 1) and 68 infants whose gestational age was 33 weeks or less (prem 2). Demographic information and a 2 ml blood sample were obtained on days 1, 5, 30, 90, and 180. Plasma was fractionated and stored at −70°C for batch assaying of the following tests: screening tests, PT, APTT; factor assays (biologic (B)); fibrinogen, II, V, VII, VIII:C, IX, X, XI, XII, prekallikrein, high molecular weight kininogen, XIII (immunologic (I)); inhibitors (I), antithrombin III, aα2-antiplasmin, α2-macroglobulin, α-anti-trypsin, Cl esterase inhibitor, protein C, protein S, and the fibrinolytic system (B); plasminogen. We have previously reported an identical study for 118 full term infants. The large number of premature and full term infants studied at varying time points allowed us to determine the following: 1) coagulation tests vary with the gestational age and postnatal age of the infant; 2) each factor has a unique postnatal pattern of maturation; 3) near adult values are achieved by 6 months of age; 4) premature infants have a more rapid postnatal development of the coagulation system compared to the full term infant; and 5) the range of reference values for two age groups of premature infants has been established for each of the assays. These reference values will provide a basis for future investigation of specific hemorrhagic and thrombotic problems in the newborn infant.

Premie Nipples: A Potential Aspiration Hazard

PEDIATRICS ◽  
1980 ◽  
Vol 65 (1) ◽  
pp. 163-164
Author(s):  
Robert G. Scherz
Keyword(s):  
United States ◽  
Premature Infants ◽  
The United States ◽  
Term Infant ◽  
Full Term ◽  
Term Infants ◽  
Full Term Infant ◽  
Retail Outlets

Nipples for dispensing milk to infants are sold throughout the United States and Canada in a diversity of retail outlets. The nipples have been designed in a variety of forms to include soft nipples for premature infants. The nipples for premature infants tend to be of thinner stock and more pliable than nipples designed for full-term infants. Although the nipples may well have labeling indicating that they have been prepared for premature infants, the adult who purchases them may not recognize that difference when they are displayed in an area that also provides standard nipples. The use of nipples designed for premature infants may present an aspiration hazard if they are used by a full-term infant.

Percentile estimates of reference values for total protein and albumin in sera of premature infants (less than 37 weeks of gestation).

1987 ◽  
Vol 33 (3) ◽  
pp. 411-413 ◽  
Author(s):  
S H Zlotkin ◽  
C W Casselman
Keyword(s):  
Premature Infants ◽  
Reference Values ◽  
Gestational Age ◽  
Total Protein ◽  
Protein Concentration ◽  
Term Infant ◽  
Full Term ◽  
Albumin Concentration ◽  
Total Protein Concentration ◽  
Term Infants

Abstract We measured the concentrations of total protein and albumin in sera of 281 well-fed premature infants, gestational ages 22-36 weeks, and calculated reference values from the 10th to 90th percentiles. The mean serum albumin concentration (27.6 +/- 4.4 g/L, mean +/- SD) and total protein concentration (49.2 +/- 6.7 g/L) at a postnatal age of 14.5 days were lower than reference values for full-term infants. We detected a significant positive correlation between albumin concentration and gestational age (r = 0.34, p less than 0.01) and total protein concentration and gestational age (r = 0.43, p less than 0.01). Even though albumin values were low, generalized edema was not present. We conclude that values for total protein and albumin in the preterm infant are lower than in the full-term infant but are an expected physiological response to premature birth.

The Auditory Steady-State Response: Full-Term and Premature Neonates

2002 ◽  
Vol 13 (05) ◽  
pp. 260-269 ◽  
Author(s):  
Barbara Cone-Wesson ◽  
John Parker ◽  
Nina Swiderski ◽  
Field Rickards
Keyword(s):  
Steady State ◽  
Premature Infants ◽  
Modulation Frequency ◽  
Otoacoustic Emission ◽  
Full Term ◽  
Steady State Response ◽  
Pass Rates ◽  
Term Infants ◽  
State Response ◽  
Auditory Steady State Response

Two studies were aimed at developing the auditory steady-state response (ASSR) for universal newborn hearing screening. First, neonates who had passed auditory brainstem response, transient evoked otoacoustic emission, and distortion-product otoacoustic emission tests were also tested with ASSRs using modulated tones that varied in frequency and level. Pass rates were highest (> 90%) for amplitude-modulated tones presented at levels ≥ 69 dB SPL. The effect of modulation frequency on ASSR for 500- and 2000-Hz tones was evaluated in full-term and premature infants in the second study. Full-term infants had higher pass rates for 2000-Hz tones amplitude modulated at 74 to 106 Hz compared with pass rates for a 500-Hz tone modulated at 58 to 90 Hz. Premature infants had lower pass rates than full-term infants for both carrier frequencies. Systematic investigation of ASSR threshold and the effect of modulation frequency in neonates is needed to adapt the technique for screening.

Neonatal Seizures, Intracerebral Hematoma, and Subarachnoid Hemorrhage in Full-Term Infants

PEDIATRICS ◽  
1979 ◽  
Vol 63 (5) ◽  
pp. 812-815
Author(s):  
Edward R. Chaplin ◽  
Gary W. Goldstein ◽  
David Norman
Keyword(s):  
Metabolic Disease ◽  
Subarachnoid Hemorrhage ◽  
Subarachnoid Space ◽  
Term Infant ◽  
Full Term ◽  
Spinal Fluid ◽  
Intracerebral Hematoma ◽  
Neonatal Seizures ◽  
Presumptive Diagnosis ◽  
Term Infants

During the first days of life intracranial hemorrhage is a frequent cause of convulsions in the full-term infant.1,2 If spinal fluid is bloody and there is no evidence of asphyxia, infection, or acute metabolic disease, then a presumptive diagnosis of primary subarachnoid hemorrhage is often made.1-3 These infants appear remarkably well in the interictal period, and their outcome is usually good.1,2 Since pathologic confirmation is not available, it has been assumed that bleeding occurs directly into the subarachnoid space and not as an extension of a subdural, intraventricular, or intracerebellar hemorrhage.1,3-5 During a 13-month period at our institution, only four full-term infants had seizures and bloody spinal fluid.

URINARY EXCRETION OF PHENOLIC AND INDOLIC COMPOUNDS, METACATECHOLAMINES, AND VMA BY FULL-TERM AND PREMATURE INFANTS

PEDIATRICS ◽  
1968 ◽  
Vol 41 (4) ◽  
pp. 777-783
Author(s):  
Demetre Nicolopoulos ◽  
Anthony Agathopoulos ◽  
Calliope Danelatou-Athanassiadou ◽  
Marianthi Bafataki
Keyword(s):  
Urinary Excretion ◽  
Phenolic Acids ◽  
Premature Infants ◽  
Homogentisic Acid ◽  
Full Term ◽  
Term Infants ◽  
Catabolic Pathways ◽  
Indolic Compounds

The 24-hour urinary excretion of phenolic and indolie compounds, metacatechol-amines, and VMA by full-term and premature infants on their first and fifteenth days of life was studied. The presence of metabolites from all three main catabolic pathways of tryptophan was noted in both groups of infants. 3-indole-acetic and 3-indole-propionic acids were present on the first day of life in the urine of full-term infants, but they were absent on the fifteenth day. Twenty phenolic acids were observed in both groups of infants, but their excretion varied a great deal. Homogentisic acid was not excreted on the first day of life of full-term and premature infants, but it was found in the urine of full-term infants on the fifteenth day of life. The variations of excretion of VMA generally followed that of metacatecholamines. The excretion of VMA by the premature infants on their fifteenth day of life is four- to fivefold that of the first day and reaches adult levels, in contrast to the moderate decrease of VMA excretion of the fuil-term infants on the fifteenth day. The degree of maturation of the enzymic systems involved is discussed as a probable cause of these variations.

Carbohydrate Malabsorption in Necrotizing Enterocolitis

PEDIATRICS ◽  
1976 ◽  
Vol 57 (2) ◽  
pp. 201-204
Author(s):  
Linda Sue Book ◽  
John J. Herbst ◽  
August L. Jung
Keyword(s):  
Necrotizing Enterocolitis ◽  
Premature Infants ◽  
Clinical Symptoms ◽  
Advanced Disease ◽  
Full Term ◽  
Term Infants ◽  
Stool Specimens ◽  
Reducing Substances ◽  
Carbohydrate Intolerance ◽  
Prospective Investigation

A prospective investigation was conducted to determine if infants with necrotizing enterocolitis had evidence of carbohydrate intolerance prior to the onset of clinical symptoms of advanced disease. Stool specimens were examined for fecal reducing substances with Clintest tablets from well, full-term infants and sick premature infants. Only two of 45 (4.4%) formula-fed, full-term infants demonstrated higher than 2 + fecal reducing substances. Ten of 14 (71%) formula-fed premature infants who developed necrotizing enterocolitis had higher than 2 + reducing substances detected in their stools. Daily measurement of fecal reducing substances can be a useful adjunct in the management of sick premature infants.

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