Relationship of Sodium Bicarbonate to Intraventricular Hemorrhage in Premature Infants with Respiratory Distress Syndrome

1980 ◽  
Vol 29 (6) ◽  
pp. 357???361 ◽  
Author(s):  
Eileen M. Reichert ◽  
Peter W. Fuller
PEDIATRICS ◽  
1963 ◽  
Vol 32 (6) ◽  
pp. 966-975 ◽  
Author(s):  
Robert Usher

In a controlled series evaluation of early administration of intravenous glucose and sodium bicarbonate, the mortality rate among 35 treated premature infants with respiratory distress syndrome was 17%, while among 35 controls it was 37% (p = 0.06). The mortality rate was similarly reduced among the total number of premature infants who have been treated by the author for this condition over the past five years: 24/118, or 20%, mortality with early intravenous therapy versus 38/94, or 42%, mortality with conventional therapy (p<0.01). Intravenous therapy had little or no effect in premature infants weighing less than 1,500 gm. With this therapy for respiratory distress syndrome, the mortality rate among 736 premature infants consecutively delivered at two hospitals was exceptionally low—5.7% of infants weighing 1,001 to 2,500 gm. There was no evidence that the therapy operated to reduce mortality by lessening the respiratory distress process, which was equally severe among treated and untreated infants. The fluids administered to these infants did not produce heart failure or fluid overload. Sudden collapse which may have been due to reactive hypoglycemia sometimes resulted, however, when intravenous therapy was stopped before the infant was receiving adequate enteral feedings. It is concluded that early administration of intravenous glucose and sodium bicarbonate to premature infants with respiratory distress (hyaline membrane) syndrome can reduce the mortality rate by two-thirds among those who weigh more than 1,500 gm.


Author(s):  
A. N. Uzunova ◽  
N. A. Onishcenko

The purpose of the study is to analyze the history and structure of the pathology of premature infants with extremely low body weight and very low body weight under dynamic follow up in the monitoring department for children of the perinatal risk group. Using the method of continuous sampling we analyzed observation maps of 95 premature infants with extremely low body weight and very low body weight of gestation age from 24 to 36 weeks.All newborns have a low Apgar score at birth and at the 5th minute, and Apgar score was lower in  children with extremely low body weight as compared with children with very low body weight. All children had congenital anomalies of the organs and systems, marked signs of immaturity, with prevailing changes in  the cardiovascular system, passability of  the renal pelvis, and congenital deformity of thigh.Among the conditions that occurred in the perinatal period, the authors diagnosed intraventricular hemorrhage in 50.5% of patients, 89.6% of them had hemorrhage of grade II – III, all children had respiratory distress syndrome. Bronchopulmonary dysplasia was diagnosed in 60% of premature infants, its moderate and severe forms in 1/3 of the patients. All children had anemia, and 13.7% of children had a neonatal syndrome from mothers with diabetes mellitus. 1/3 of premature infants had retinopathy; its frequency did not depend on the body weight at birth. All children had a combination of pathologies. Bronchopulmonary dysplasia was combined with respiratory distress syndrome and anemia in 100% of children. The combination of bronchopulmonary dysplasia with intraventricular hemorrhage was more often recorded in patients with extremely low body weight than in patients with very low body weight. 


1981 ◽  
Vol 15 ◽  
pp. 667-667
Author(s):  
Alan H Klein ◽  
Barbara Foley ◽  
Thomas P Foley ◽  
Hugh H Macdonald ◽  
Delbert A Fisher

PEDIATRICS ◽  
1973 ◽  
Vol 52 (6) ◽  
pp. 850-854 ◽  
Author(s):  
H. William Taeusch ◽  
Nai San Wang ◽  
Melvin Baden ◽  
Charles R. Bauer ◽  
Leo Stern

The pathological findings from seven infants who died with respiratory distress syndrome and had been treated with placebo are compared with seven infants with comparable disease treated with hydrocortisone. Differences in lung, liver, adrenal, thymus, heart and spleen pathology attributable to steroid treatment did not occur between the two groups. A statistically significant association was found between intraventricular hemorrhage and steroid treatment. The pathological findings are consistent with the clinical results in that no beneficial effect occurs when steroids are used after an infant manifests respiratory distress. The possibility that elevated steroid levels increase the likelihood of intraventricular hemorrhage in association with respiratory distress syndrome is raised by these observations, although further information is needed to establish such a relationship.


PEDIATRICS ◽  
1973 ◽  
Vol 52 (6) ◽  
pp. 782-787 ◽  
Author(s):  
Melvin Baden ◽  
Charles R. Bauer ◽  
Eleanor Colle ◽  
George Klein ◽  
Apostolos Papageorgiou ◽  
...  

Plasma total corticosteroid concentrations were measured in 44 premature infants with the respiratory distress syndrome (RDS). Further assay of serum concentrations of cortisol, cortisone, corticosterone, corticosterone sulfate, and 11-deoxycorticosterone sufate was carried out in 24 of these infants and in 10 healthy, nonstressed premature controls. Infants with RDS had higher concentrations of cortisol (22.1±4.3µg/100 ml) and corticosterone sulfate (7.7 ± 0.8 µg/100 ml) than control infants (6.6 ± 0.8 µg/100 ml, 1.2 ± 0.3 µg/100 ml, and 4.2 ± 0.4 µg/100 ml, respectively). A significant correlation was found with the five-minute Apgar score (negative correlation, p = 0.005) and a possible correlation with the A-aDO2 gradient. Among premature infants with RDS, those of 32 weeks' gestation or less had higher concentrations of cortisol (28.3 ± 23.6 µg/100 ml) and corticosterone (3.9 ± 2.7 µg/100 ml) than those of more than 32 weeks (11.5 ± 5.4 µg/100 ml and 1.7 ± 0.7 µg/100 ml, respectively), suggesting either elevated response to stress or a diminished ability to metabolize these compounds.


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