Remifentanil Degradation in Umbilical Cord Blood of Preterm Infants

Background No pharmacokinetic data about remifentanil in preterm infants exist, although remifentanil is increasingly used in this especially vulnerable subgroup of pediatric patients. Unfortunately, ethical restrictions in the volume of blood that can be withdrawn for kinetic sampling nearly prohibit pharmacokinetic studies in preterm infants. Methods Because remifentanil is rapidly metabolized by nonspecific blood esterases, we collected umbilical cord serum of preterm and term infants to investigate whether the activity of nonspecific blood esterases depends on gestational age. Umbilical cord serum, buffer solution, ascorbic acid, and remifentanil were mixed in a glass vial placed in a shaking water bath at 37°C. Subsequently, serum samples were subjected to liquid chromatography-mass spectrometry-based analysis of remifentanil and its metabolite GR90291 after 0, 30, 60, 100, and 150 min. Results We analyzed umbilical cord serum samples of 34 preterm infants (24-36 gestational weeks) and six term infants. The degradation rates of remifentanil to its major metabolite GR90291 were comparable in preterm and term infants. The overall median degradation half-life of remifentanil was 143 ± (interquartile range) 47 min (minimum, 76 min; maximum, 221 min) without significant differences between very preterm infants (less than 28 gestational weeks) and term infants. The remifentanil concentration remained stable in control runs without serum. Conclusions Our study demonstrates that very preterm infants exhibit a high nonspecific esterase activity in umbilical cord blood that is comparable with that of term infants. These results support clinical experiences that remifentanil is rapidly metabolized by preterm infants without prolonged side effects.

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Influence of Timing of Antenatal Glucocorticoid Exposure on Umbilical Cord Blood Neurotrophins Concentration in Appropriately Grown and Growth Restricted Very Preterm Infants

Journal of Paediatrics and Child Health ◽

10.1111/jpc.13882_119 ◽

2018 ◽

Vol 54 ◽

pp. 47-48

Keyword(s):

Cord Blood ◽

Preterm Infants ◽

Umbilical Cord ◽

Umbilical Cord Blood ◽

Very Preterm Infants ◽

Very Preterm

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Umbilical Cord Blood Adiponectin, Leptin, Insulin, and Ghrelin in Premature Infants and Their Association With Birth Outcomes

Frontiers in Endocrinology ◽

10.3389/fendo.2021.738964 ◽

2021 ◽

Vol 12 ◽

Author(s):

Luyan Han ◽

Bo Li ◽

Xiaojing Xu ◽

Shufang Liu ◽

Zhenghong Li ◽

...

Keyword(s):

Birth Weight ◽

Cord Blood ◽

Preterm Infants ◽

Umbilical Cord ◽

Fetal Growth ◽

Umbilical Cord Blood ◽

Gestational Age ◽

Metabolic Diseases ◽

Term Infants ◽

Preterm Group

BackgroundPremature/low-birth-weight infants are at significant risk of metabolic diseases in adulthood, which may be related to the levels of fetal adipokine. Here, we investigated the differences in the levels of umbilical cord blood adiponectin, leptin, insulin, and ghrelin in preterm and term infants and sought to elucidate the link between these hormones and fetal growth. We also evaluated the interrelationship among these metabolic hormones in both groups of newborns.MethodsA total of 149 mother–infant pairs (100 in the preterm group and 49 in the term group) were enrolled in the study. The preterm group was further subdivided according to birth weight (≤1,500, 1,501–2,000, 2,001–2,500, and >2,500 g), gestational age (<34 vs. ≥34 weeks), and appropriate for gestational age (AGA) vs. small for gestational age (SGA). The general condition of the mothers and the growth parameters of the newborns at birth were recorded.ResultsThe levels of adiponectin, leptin, and ghrelin were lower in the preterm group than those in the term group (p < 0.05). In the preterm group, the leptin levels of infants with gestational age ≥34 weeks were significantly higher than those of infants with gestational age <34 weeks (mean ln leptin = 0.63 vs. 0.36 ng/ml, p = 0.009). The levels of adiponectin were lower in the SGA group than those in the AGA group (mean ln adiponectin = 2.26 vs. 2.84 µg/ml, p = 0.001), whereas those of ghrelin displayed the opposite trend (mean ln ghrelin = 6.29 vs. 5.71 pg/ml, p < 0.001). Leptin was significantly correlated with insulin both in preterm infants with birth weight (BW) >2,000 g and in term infants. Umbilical cord blood leptin was positively correlated with the BW, birth length, and head circumference of newborns (r = 0.460, 0.311, and 0.310, respectively, all p < 0.05), whereas ghrelin was negatively correlated with the same parameters (r = −0.372, −0.415, and −0.373, respectively, all p > 0.05).ConclusionsThe lack of maturation of adipose tissue and the gastrointestinal tract by the fetus due to prematurity is associated with changes in the levels of cord blood adiponectin, leptin, and ghrelin. The dysregulation of these hormones in preterm infants may be a risk factor for fetal growth and future metabolic diseases.

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106: Umbilical Cord Blood Cortisol Levels and Hemodynamic Status on the First Day of Life in Preterm Infants Less than 32 Weeks Gestation

Paediatrics & Child Health ◽

10.1093/pch/20.5.e72a ◽

2015 ◽

Vol 20 (5) ◽

pp. e72-e72

Author(s):

S Manickaraj ◽

S Buddhavarapu ◽

N Brown ◽

K Yusuf

Keyword(s):

Cord Blood ◽

Preterm Infants ◽

Umbilical Cord ◽

Umbilical Cord Blood ◽

Hemodynamic Status ◽

Cortisol Levels

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Body Composition in Very Preterm Infants: Role of Neonatal Characteristics and Nutrition in Achieving Growth Similar to Term Infants

Neonatology ◽

10.1159/000450882 ◽

2016 ◽

Vol 111 (3) ◽

pp. 214-221 ◽

Cited By ~ 10

Author(s):

Geneviève Tremblay ◽

Christine Boudreau ◽

Sylvie Bélanger ◽

Odette St-Onge ◽

Etienne Pronovost ◽

...

Keyword(s):

Body Composition ◽

Preterm Infants ◽

Term Infants ◽

Very Preterm Infants ◽

Very Preterm

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Allogeneic Umbilical Cord Blood Red Cell Concentrates: An Innovative Blood Product for Transfusion Therapy of Preterm Infants

Neonatology ◽

10.1159/000368296 ◽

2014 ◽

Vol 107 (2) ◽

pp. 81-86 ◽

Cited By ~ 12

Author(s):

Maria Bianchi ◽

Carmen Giannantonio ◽

Serena Spartano ◽

Maria Fioretti ◽

Alessandra Landini ◽

...

Keyword(s):

Cord Blood ◽

Preterm Infants ◽

Umbilical Cord ◽

Umbilical Cord Blood ◽

Blood Product ◽

Red Cell ◽

Transfusion Therapy

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The Effect of Platelets on Thrombin Generation in Cord Blood and Peripheral Neonatal Blood in the Premature Infant; The Event Study

Blood ◽

10.1182/blood-2021-150960 ◽

2021 ◽

Vol 138 (Supplement 1) ◽

pp. 3188-3188

Author(s):

Claire Anne Murphy ◽

Elaine Neary ◽

Barry Kevane ◽

Daniel O'Reilly ◽

John O'Loughlin ◽

...

Keyword(s):

Cord Blood ◽

Umbilical Cord ◽

Extracellular Vesicles ◽

Umbilical Cord Blood ◽

Research Funding ◽

Thrombin Generation ◽

Phospholipid Content ◽

Term Infants ◽

Time To Peak ◽

Neonatal Blood

Abstract Introduction Infants born very preterm (<32 weeks) are at increased risk of haemorrhage, particularly intraventricular haemorrhage which can result in short and long term morbidity. Routine clinical laboratory tests such as the prothrombin time and activated partial thromboplastin time are frequently abnormal in this patient group but do not appear to correlate with clinical outcomes. Moreover, while reduced levels of circulating coagulation factors and platelet hypo-reactivity have been reported, plasma thrombin generation (TG), has been reported to be similar or even enhanced in very preterm infants when compared to term infants. Extracellular vesicles, comprising of lipid-bound nanoparticles released from cells (including platelets), may potentially play a role in modulating neonatal haemostasis. We aimed to characterize phospholipid (PL)-dependent plasma thrombin generation in platelet-rich (PRP) and platelet-poor plasma (PPP) in premature infants in both umbilical cord blood & peripheral neonatal blood using calibrated automated thrombography (CAT). Methods In this prospective observational study, PRP and PPP was prepared by centrifugation from citrated umbilical cord blood and peripheral neonatal blood collected from premature infants (24 - 31 weeks) and healthy term controls (>37 weeks). No samples were collected from heparinised lines. Parameters of plasma thrombin generation in PRP were assessed using CAT, with thrombin generation stimulated by tissue factor only (TF; final concentration 1pM). CAT was also repeated in PPP using only TF and no exogenous PL (rendering the assay dependent upon the endogenous PL content of plasma). Results In the analysis of umbilical cord blood PRP, plasma thrombin generation was accelerated in the preterm infant group with a significantly shorter time to peak TG observed. The other parameters of TG were similar in both groups (Table 1). In the subset of infants from whom peripheral blood samples were available, there was further evidence of enhanced plasma TG in preterm PRP relative to term infants (Table 2). In this subgroup, the lag time and time to peak thrombin were significantly shorter in the preterm group and peak thrombin was significantly higher. TG was also assessed in both PPP and PRP prepared from umbilical cord blood samples in a subgroup of infants (n=10 term, n=6 preterm) using 1pM TF only, rendering the assay dependent on the phospholipid content of plasma. No difference was observed in any CAT parameters, suggesting that neonatal PPP phospholipid content (potentially from circulating extracellular vesicles) is sufficient to support thrombin generation in the absence of exogenous phospholipid. Conclusion These preliminary data suggest that neonatal PRP, measured in both umbilical cord blood and peripheral neonatal blood, has similar thrombin generation or may even be hypercoagulable, compared with healthy term controls. Moreover, neonatal plasma phospholipid appears to support thrombin generation in the absence of exogenous phospholipid. This ongoing prospective study aims to further characterize the platelet-dependency of neonatal thrombin generation and evaluate the potential role of extracellular vesicles in neonatal haemostasis. Figure 1 Figure 1. Disclosures Maguire: Actelion: Research Funding; Bayer Pharma: Research Funding. Ni Ainle: Leo Pharma: Research Funding; Actelion: Research Funding; Daiichi-Sankyo: Research Funding; Bayer Pharma: Research Funding.

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A Comparison of the Percentage of Fetal Hemoglobin in Human Umbilical Cord Blood as Determined by Chromatography and by Alkali Denaturation

Blood ◽

10.1182/blood.v22.5.554.554 ◽

1963 ◽

Vol 22 (5) ◽

pp. 554-565 ◽

Cited By ~ 18

Author(s):

DAVID H. ARMSTRONG ◽

W. A. SCHROEDER ◽

WILLIAM D. FENNINGER

Keyword(s):

Cord Blood ◽

Umbilical Cord ◽

Umbilical Cord Blood ◽

Fetal Hemoglobin ◽

Full Term ◽

Human Umbilical Cord Blood ◽

Human Umbilical Cord ◽

Careful Study ◽

Term Infants ◽

Accuracy And Precision

Abstract A comparison has been made of the determination of fetal hemoglobin in human umbilical cord blood by column chromatography and alkali denaturation. A careful study has also been made of the variables that control the accuracy and precision of the methods. Minor modification has led to much improved control of the 1-minute alkali denaturation procedure. The percentage of fetal hemoglobin in the umiblical cord blood of full term infants has been found to cover a far narrower range than is commonly reported. By chromatography, the average is 85.5 per cent with a range from 79 to 91 per cent that includes more than 95 per cent of normal full term infants. By alkali denaturation, the average is 74.0 per cent with a range from 63 to 87 per cent. Possible correlations with several clinical parameters have been examined. The highest correlation by both methods of determination occurred in the group of 12 samples from infants with a duration of gestation less than 37 weeks. In this group the linear correlation with weight was greater than 0.6. The precision and accuracy of the chromatographic method recommend it in the study of such subjects as prematurity, twinning, dysmaturity, intrauterine growth retardation, and infants of diabetic mothers.

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Autologous Umbilical Cord Blood‐Derived Cell Administration in Extreme Preterm Infants: CORD‐SAFE Study

Stem Cells Translational Medicine ◽

10.1002/sctm.12814 ◽

2020 ◽

Vol 9 (S1) ◽

Author(s):

Atul Malhotra ◽

Lindsay Zhou ◽

Iona Novak ◽

Courtney McDonald ◽

Suzanne Miller ◽

...

Keyword(s):

Cord Blood ◽

Preterm Infants ◽

Umbilical Cord ◽

Umbilical Cord Blood

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Establishing Relationship Between Maternal Sociodemographic Characteristics and Lead in Umbilical Cord Blood Serum

Research in Pharmacy and Health Sciences ◽

10.32463/rphs.2018.v04i01.01 ◽

2018 ◽

Vol 4 (1) ◽

pp. 404-410

Author(s):

Nazia Tarannum ◽

Ranu Agarwal ◽

Amit Upadhyay ◽

Priyanka Gupta ◽

Rakesh Kumar Soni

Keyword(s):

Blood Serum ◽

Cord Blood ◽

Umbilical Cord ◽

Umbilical Cord Blood ◽

Lead Concentration ◽

Serum Samples ◽

Cord Blood Serum ◽

Piped Water ◽

Umbilical Cord Blood Serum ◽

Epidemiological Characteristics

Aim: To find the correlation between the concentration of lead and maternal socio-demographic characteristics like age, living area (urban or rural), housing style (slum type, cemented, or floored), living place (near industry or far from industry), water supply (piped water or direct water from source) and epidemiological characteristics like mother’s occupation, mother’s gestation age, mother’s active smoking habit. Method: A total of 100 umbilical cord blood serum samples were collected from Lala Lajpat Rai Medical College, Meerut and estimation of lead was done using Graphite Furnace Atomic Absorption Spectroscopy (AAS). This study was conducted between April 2014 and March 2015. Result and conclusions: Data suggested that the percentage of lead is more in cord blood serum samples of mother who are working and are non-housewife and residing in urban area due to exposure to traffic, industries and pollution. The correlation of mother’s working place with lead concentration showed that the mothers who were industrial worker had more lead concentration whereas the level of heavy metal was found elevated in mother’s who are drinking piped water. The data suggested that the mothers who smoked have more lead concentration in comparison to non-smoking mother.

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