Photoactive Water-Soluble Vitamin K: A Novel Amphiphilic Photoinduced Antibacterial Agent

Haemorrhages occurring in the newborn without trauma have been observed by obstetricians since the 17th century, but were considered different diseases depending on their location. Umbilical haemorrhage associated with obstructed bile canals was described by Cheyne in 1802. Grandidier in 1871 and Townsend in 1894 grouped together various forms of neonatal bleeds and associated them with disturbed coagulation. When the clotting system became better understood in the last decade of the 19th century, effective symptomatic treatment was developed: gelatine, serum injection, and the transfusion of fresh blood. In 1935, Dam detected the function of vitamin K in the coagulation system and 4 years later, Waddell introduced vitamin K administration into therapy and prevention of neonatal haemorrhagic disease. When high doses of synthetic water-soluble vitamin K analogues were given to preterm infants, kernicterus occurred, reminding physicians that progress in neonatal therapy rests on the cornerstones of controlled trials and follow-up.

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Effects of Intravenously Injected Vitamin K1and Water-Soluble Vitamin K (Menadione Sodium Bisulphite) on Hypo-prothrombinnemia during Anticoagulation Treatment

Acta Medica Scandinavica ◽

10.1111/j.0954-6820.1955.tb15727.x ◽

2009 ◽

Vol 150 (6) ◽

pp. 437-442 ◽

Cited By ~ 3

Author(s):

H. STÜRUP

Keyword(s):

Vitamin K ◽

Water Soluble ◽

Sodium Bisulphite ◽

Anticoagulation Treatment ◽

Water Soluble Vitamin

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Letters to the Editor

PEDIATRICS ◽

10.1542/peds.16.3.424 ◽

1955 ◽

Vol 16 (3) ◽

pp. 424-424

Author(s):

ELMER L. SEVERINGHAUS

Keyword(s):

Vitamin E ◽

Premature Infants ◽

Vitamin K ◽

Water Soluble ◽

Letters To The Editor ◽

Vitamin E Deficiency ◽

Small Series ◽

Water Soluble Vitamin ◽

Factor Problem ◽

Hemolytic Effect

A warning needs to be given pediatricians and obstetricians about using unduly large doses of any water soluble vitamin K preparation in premature infants. Communications appearing in Lancet report fatal hemolytic anemia occurring in two small series of infants. The vitamin K was given in one on more doses of 10 mg. to these premature infants. No evidence of blood group incompatibility or Rh factor problem was found. A further report appeared in substantiation of the hemolytic effect of very large doses (100 mg./kg.) of water soluble vitamin K given to rats. This hemolysis occurred only in rats deprived of vitamin E. It is known that vitamin E deficiency in rats leads to abnormally great hemolytic tendency.

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Effect of Vitamin-K Dosage on Plasma-Bilirubin Levels in Premature Infants

PEDIATRICS ◽

10.1542/peds.18.3.377 ◽

1956 ◽

Vol 18 (3) ◽

pp. 377-377

Keyword(s):

Single Dose ◽

Premature Infants ◽

Vitamin K ◽

Intramuscular Injection ◽

Present Report ◽

Water Soluble ◽

Premature Babies ◽

Water Soluble Vitamin ◽

Plasma Bilirubin ◽

Small Doses

Recent reports have indicated that administration of large doses of a water-soluble vitamin-K analogue (Synkavit) causes an increase in the bilirubin in the serum and was potentially dangerous as regards the development of kernicterus in premature infants. The present report compares the effects of large and small doses of the water-soluble vitamin-K analogue (Synkavit) on the bilirubin in the plasma of premature babies on the fifth day of life. One group of premature babies received 10 mg of Synkavit daily by intramuscular injection for 3 days. Another group received an injection of 1 mg of Synkavit on the first day of life. The bilirubin attained a concentration of 18 mg/100 ml or higher in the plasma in 21 out of 55 babies in the first group receiving the larger dose, while only 2 premature infants out of 51 who received the smaller dose developed a concentration of bilirubin in the plasma of 18 mg/100 ml or higher. There were two deaths from kernicterus in the group receiving the larger dose and no deaths or signs of kernicterus in the group receiving the smaller dose. It is pointed out that a single dose of 0.5 to 1.0 mg of vitamin-K is as effective as larger doses in preventing postnatal hypoprothrombinemia. It is suggested that the routine use of the smaller dose should be adopted in an effort to reduce the incidence of kernicterus in premature infants.

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