Effect of a single breath of 100% oxygen on respiration in neonates during sleep

1984 ◽  
Vol 57 (5) ◽  
pp. 1531-1535 ◽  
Author(s):  
T. Aizad ◽  
J. Bodani ◽  
D. Cates ◽  
L. Horvath ◽  
H. Rigatto
Keyword(s):  
Gestational Age ◽  
Minute Ventilation ◽  
Control Period ◽  
Full Term ◽  
Preterm Neonates ◽  
Sleep State ◽  
Quiet Sleep ◽  
Peripheral Chemoreceptor ◽  
Term Infants ◽  
Single Breath

To determine the effect of a single breath of 100% O2 on ventilation, 10 full-term [body wt 3,360 +/- 110 (SE) g, gestational age 39 +/- 0.4 wk, postnatal age 3 +/- 0.6 days] and 10 preterm neonates (body wt 2,020 +/- 60 g, gestational age 34 +/- 2 wk, postnatal age 9 +/- 2 days) were studied during active and quiet sleep states. The single-breath method was used to measure peripheral chemoreceptor response. To enhance response and standardize the control period for all infants, fractional inspired O2 concentration was adjusted to 16 +/- 0.6% for a control O2 saturation of 83 +/- 1%. After 1 min of control in each sleep state, each infant was given a single breath of O2 followed by 21% O2. Minute ventilation (VE), tidal volume (VT), breathing frequency (f), alveolar O2 and CO2 tension, O2 saturation (ear oximeter), and transcutaneous O2 tension were measured. VE always decreased with inhalation of O2 (P less than 0.01). In quiet sleep, the decrease in VE was less in full-term (14%) than in preterm (40%) infants (P less than 0.001). Decrease in VE was due primarily to a drop in VT in full-term infants as opposed to a fall in f and VT in preterm infants (P less than 0.05). Apnea, as part of the response, was more prevalent in preterm than in full-term infants. In active sleep the decrease in VE was similar both among full-term (19%) and preterm (21%) infants (P greater than 0.5). These results suggest greater peripheral chemoreceptor response in preterm than in full-term infants, reflected by a more pronounced decrease in VE with O2. The results are compatible with a more powerful peripheral chemoreceptor contribution to breathing in preterm than in full-term infants.

Periodic Apnea in the Full-Term Infant: Individual Consistency, Sex Differences, and State Specificity

PEDIATRICS ◽  
1982 ◽  
Vol 70 (1) ◽  
pp. 79-86
Author(s):  
Stephen P. Waite ◽  
Evelyn B. Thoman
Keyword(s):  
Periodic Breathing ◽  
Term Infant ◽  
Full Term ◽  
Respiratory Pattern ◽  
Active Sleep ◽  
Sleep State ◽  
Quiet Sleep ◽  
Term Infants ◽  
The Mean ◽  
Individual Consistency

The occurrence of periodic apnea (apnea during periodic breathing) was studied in 27 normal, full-term infants during the first five weeks of life. The rate and mean length of apnea were analyzed both with respect to sleep state and with respect to respiratory pattern, ie, periodic vs nonperiodic breathing. The rate of apnea was found to vary according to sleep state and the pattern of breathing. The highest apnea rates were non-periodic apneas in active sleep. Periodic apnea rates were relatively low in both active and quiet sleep; however, this type of apnea was consistently observed from weeks 2 through 5. The proportion of apneas that are periodic is much higher in quiet sleep than in active sleep. Rates of periodic and nonperiodic apnea were more consistently correlated in active sleep than in quiet sleep. The mean length of periodic apnea was found to be significantly greater than the mean length of nonperiodic apnea in both sleep states, a difference that reflected a greater positive skew in the distribution of the nonperiodic apnea lengths. This variation in length between periodic and nonperiodic apnea explains, in part, the increased mean length in quiet sleep compared with active sleep. There were significant individual differences over weeks in both forms of apnea in active sleep and in quiet sleep. Female infants were observed to have higher rates of nonperiodic apnea than male infants in active sleep, although no significant differences in the distribution of lengths were obtained.

Transient ventilatory response to CO2 as a function of sleep state in full-term infants

1983 ◽  
Vol 54 (6) ◽  
pp. 1482-1488 ◽  
Author(s):  
J. V. Anderson ◽  
R. J. Martin ◽  
E. F. Abboud ◽  
I. Z. Dyme ◽  
E. N. Bruce
Keyword(s):  
Steady State ◽  
Ventilatory Response ◽  
Minute Ventilation ◽  
Full Term ◽  
Initial Increase ◽  
Sleep State ◽  
Term Infants ◽  
Co2 Partial Pressure ◽  
End Tidal ◽  
Ventilatory Response To Co2

The influence of sleep state on the transient (i.e., initial 60 s) and steady-state ventilatory responses to 2% CO2 inhalation was studied in 19 healthy full-term infants. A nasal mask pneumotachometer was used to measure ventilation and end-tidal CO2 partial pressure (PCO2) and enabled abrupt changes in the inspired gas concentration to be made. The magnitude of the change in minute ventilation for both the transient and steady-state responses to CO2 was not statistically different between active (AS) and quiet (QS) sleep. Nonetheless the greater variability in minute ventilation during AS compared with QS continued throughout the period of CO2 inhalation and was associated with a more variable change in ventilation in the individual infants during AS. There was a greater increase in end-tidal PCO2 over the first 60 s during AS (3.3 +/- 0.3 vs. 2.6 +/- 0.2 Torr, in AS and QS, respectively, P less than 0.03). This may indicate a smaller initial increase in alveolar ventilation, relative to CO2 delivery to the lungs, in response to CO2 inhalation during AS. Asynchronous chest wall movements were more common during AS than QS (P less than 0.005) and did not change with CO2. The inconsistent transient ventilatory response to CO2 during AS compared with QS may be important in the behavior of infants to spontaneous episodes of hypercapnia occurring during AS.

scholarly journals Newborn Screening for Severe Combined Immunodeficiency: Do Preterm Infants Require Special Consideration?

2021 ◽  
Vol 7 (3) ◽  
pp. 40
Author(s):  
Anne E. Atkins ◽  
Michael F. Cogley ◽  
Mei W. Baker
Keyword(s):  
Newborn Screening ◽  
Premature Infant ◽  
Gestational Age ◽  
Linear Regression Analysis ◽  
Severe Combined Immunodeficiency ◽  
Cell Receptor ◽  
Full Term ◽  
Combined Immunodeficiency ◽  
Term Infants ◽  
Preterm Newborns

The Wisconsin Newborn Screening (NBS) Program began screening for severe combined immunodeficiency (SCID) in 2008, using real-time PCR to quantitate T-cell receptor excision circles (TRECs) in DNA isolated from dried blood NBS specimens. Prompted by the observation that there were disproportionately more screening-positive cases in premature infants, we performed a study to assess whether there is a difference in TRECs between full-term and preterm newborns. Based on de-identified SCID data from 1 January to 30 June 2008, we evaluated the TRECs from 2510 preterm newborns (gestational age, 23–36 weeks) whose specimens were collected ≤72 h after birth. The TRECs from 5020 full-term newborns were included as controls. The relationship between TRECs and gestational age in weeks was estimated using linear regression analysis. The estimated increase in TRECs for every additional week of gestation is 9.60%. The 95% confidence interval is 8.95% to 10.25% (p ≤ 0.0001). Our data suggest that TRECs increase at a steady rate as gestational age increases. These results provide rationale for Wisconsin’s existing premature infant screening procedure of recommending repeat NBS following an SCID screening positive in a premature infant instead of the flow cytometry confirmatory testing for SCID screening positives in full-term infants.

Oral acetaminophen administration for patent ductus arteriosus (PDA) closure in preterm neonates

2021 ◽  
Vol 43 (3) ◽  
pp. 254-259
Author(s):  
Mahmood Samadi ◽  
Zahra Nabaee ◽  
Manizheh Mostafagharebaghi ◽  
Majid Mahalei ◽  
Elham Sheykhsaran ◽  
...  
Keyword(s):  
Patent Ductus Arteriosus ◽  
Gestational Age ◽  
Statistical Significance ◽  
Ductus Arteriosus ◽  
Preterm Neonates ◽  
Term Infants ◽  
Treatment Data ◽  
Kolmogorov Smirnov ◽  
Study Population ◽  
Patent Ductus

Background: Patent Ductus Arteriosus (PDA) is considered one of the most prevalent types of congenital heart disease. The closure of the ductus arteriosus physiologically occurs at the first 48-72 hours after the birth in healthy term infants. Different causes can result in the pathological opening of ductus arteriosus. This study aims to investigate the effect of oral acetaminophen on the closure of PDA in preterm neonates. Methods: The present study is a trial without control. Forty-five preterm neonates with a gestational age of <32 weeks were studied. Acetaminophen was orally administered with a dose of 10mg/kg every 6 hours for three days. Closure of ductus arteriosus was considered as the success of treatment. Data were analyzed using SPSS 15. Data were reported as )frequency-percent) and mean ± SD. To evaluate the normal distribution of data, we used a Kolmogorov-Smirnov test. Statistical significance was defined as P<0.05. Results: The study population consisted of 20 male and 25 female infants with the mean gestational age of 28.95 ± 1.66 weeks. Cesarean-born infants and vaginal-born infants consisted 17.8% and 82.2% of the study population, respectively. The proportion of PDA closure after administration of oralacetaminophen was 82.3%. Conclusion: The current study indicates that oral acetaminophen is highly effective in closing PDA. Considering its trivial side effects, it has the potency to be a convenient option for treating this condition.

scholarly journals Visual function and fine-motor control in small-for-gestational age infants

2004 ◽  
Vol 62 (4) ◽  
pp. 955-962 ◽  
Author(s):  
Heloisa G.R.G. Gagliardo ◽  
Vanda M.G. Gonçalves ◽  
Maria Cecilia M.P. Lima ◽  
Maria de Fatima de C. Francozo ◽  
Abimael Aranha Netto
Keyword(s):  
Motor Control ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Visual Function ◽  
Infant Development ◽  
Full Term ◽  
Fine Motor ◽  
Genetic Syndromes ◽  
Fine Motor Control ◽  
Term Infants

OBJECTIVE: To compare visual function and fine-motor control of full-term infants small-for-gestational age (SGA) and appropriate for gestational age (AGA), in the first three months. METHOD: We evaluated prospectively 31 infants in the 1st month; 33 in the 2nd and 34 infants in the 3rd month, categorized as full-term; birth weight less than 10th percentile for SGA and 25th to 90th percentile for the AGA group. Genetic syndromes, infections, multiple congenital malformations were excluded. The Bayley Scales of Infant Development-II were used, especially items related to visual function and to fine-motor control outcomes. RESULTS: The Motor Index Score (IS) was significantly lower in the SGA group in the 2nd month. The items "attempts to bring hands to mouth", in the 1st month and "reaches for suspended ring", in the 3rd month showed higher frequency in the SGA group. CONCLUSION: The Motor IS was lower in the 2nd month and items of fine-motor control in the 1st month and in the 3rd month showed higher frequency in the SGA group.

Neonatal Polycythemia: I. Early Diagnosis and Incidence Relating to Time of Sampling

PEDIATRICS ◽  
1984 ◽  
Vol 73 (1) ◽  
pp. 7-10 ◽  
Author(s):  
Mordechai Shohat ◽  
Paul Merlob ◽  
Salomon H. Reisner
Keyword(s):  
Early Diagnosis ◽  
Cord Blood ◽  
Gestational Age ◽  
Linear Correlation ◽  
Blood Viscosity ◽  
Full Term ◽  
Peripheral Vein ◽  
Dynamic Changes ◽  
Term Infants ◽  
Appropriate For Gestational Age

The dynamic changes occurring in hematocrit and blood viscosity within the first 18 hours of life were studied in 50 full-term infants who were vaginally delivered and had weight appropriate for gestational age. In all cases, the cord was clamped within 30 seconds and cord blood was collected from the vein and artery. Subsequently, samples were taken from a peripheral vein at ages 15 minutes, and 2, 4, 6, and between 12 to 18 hours. Both the Hct and blood viscosity reach their peak at age 2 hours. The incidence of neonatal polycythemia varied greatly with age. Thus at the age of 2 hours, ten infants (20%) were polycythemic, whereas by age 6 hours only six (12%) of these infants were still polycythemic and by age 12 to 18 hours only one infant (2%) was polycythemic. A linear correlation was found between cord Hct levels and peripheral venous Hct levels by age 2 hours. None of the infants with cord blood Hct levels ≤56% had developed polycythemia, whereas ten of the 12 infants with cord Hct levels &gt;56% developed polycythemia. In this particular group of infants, cord blood Hct levels may be used for the screening of neonatal polycythemia.

Alveolar Macrophages in Perinatal Infants

PEDIATRICS ◽  
1984 ◽  
Vol 74 (2) ◽  
pp. 221-223 ◽  
Author(s):  
Elizabeth Alenghat ◽  
John R. Esterly
Keyword(s):  
Gestational Age ◽  
Alveolar Macrophages ◽  
Full Term ◽  
Postnatal Life ◽  
Term Infants ◽  
Pulmonary Lesions ◽  
Neonatal Lung

The presence of alveolar macrophages in the neonatal lung at the time of autopsy is correlated with the presence of pulmonary lesions and with the duration of postnatal life. Alveolar macrophages were noted at 20 weeks of gestation in infants with congenital pneumonia, but were not present in most full-term infants who were stillborn. They were found in nearly all infants who survived for 48 hours irrespective of pulmonary lesions or gestational age.

scholarly journals Head circumference and anterior fontanel measurements in newborns

2012 ◽  
Vol 52 (3) ◽  
pp. 145 ◽  
Author(s):  
Rizal Agus Tiansyah ◽  
Irawan Mangunatmadja ◽  
Aman Pulungan
Keyword(s):  
Gestational Age ◽  
Head Circumference ◽  
Full Term ◽  
Brain Growth ◽  
Anterior Fontanel ◽  
Term Infants ◽  
Head Growth ◽  
Term Newborns ◽  
Male Subjects ◽  
The Brain

Background Head growth and anterior fontanel (AP) closureare passive processes in response to brain growth. The growthof the brain and skull starts in the third week of intrauterinegestation. roth processes run simultaneously as a part of integralgrowth, along 'With increasing gestational age, until post􀀿birth.Measurement of head circumference (He) and AF in newbornsis done to determine if the brain and skull grew normally duringthe intrauterine period.Objectives To investigate the differences in He and AF sizebetween preterm and full􀀿term infants, and the relationshipbetween gestational age (GA) and birth weight (BW) to Heand AF size.Methods This was a descriptive analytic study on preterm andfull􀀿term newborns. Measurement of HC and AF was conductedin three phases: just after birth, 1x24 and 2x24 hours of age.Analysis of HC and AF size differences between preterm and fullterm subjects was performed, as well as analysis of the correlationbetween GA and BW to HC and AF size.Results Two hundred fifty newborns completed the study. Therewere 180 full􀀿term and 70 preterm subjects. Median HC in full􀀿term and preterm male subjects were 34 cm (range 31􀀿37 cm)and 31 cm (27􀀿34 cm), respectively. Median HC in full􀀿termand preterm female subjects were 33 cm (31􀀿36 cm) and 32 cm(27􀀿3S.S cm), respectively. Median AF in full􀀿term and pretermmale subjects were 2.17 cm (1.0SA.6 cm) and 2.22 cm (1.3SA.Scm), respectively, and in full􀀿term and preterm female subjectswere 2.02 cm (lA.1S cm) and 2.22 cm (0.7SA cm), respectively.The HC of preterms were significantly lower than the fullterms(P<O.OOl), however the AF size was not different between these2 groups of newborns (P =0 .28). Correlation test between GA andBW to HC size revealed a positive correlation (r=0.620, P<O.OO 1and r=0.801, P<O.OOl, respectively), but not to AF size (r=􀀿 0.06,p􀁀 0.279 and F- 0.049, P􀁀0.44, respectively).Concl usions We found that the HC size of pre terms wassignificantly lower than thefullterms, but no significant differences in AF size between the two groups. GA and BW were associatedwith HC size, but not associated to AF size. [paediatr lndones.2012;52:145-51].

scholarly journals Proposed Plasma Ammonia Reference Intervals in a Reference Group of Hospitalized Term and Preterm Neonates

2020 ◽  
Vol 5 (2) ◽  
pp. 363-369
Author(s):  
Theresa Madigan ◽  
Darci R Block ◽  
William A Carey ◽  
Bethany D Kaemingk ◽  
Robin Patel
Keyword(s):  
Gestational Age ◽  
Reference Group ◽  
Reference Intervals ◽  
Preterm Neonates ◽  
Blood Collection ◽  
Blood Draw ◽  
Inborn Errors ◽  
Term Infants ◽  
Collection Method ◽  
Plasma Ammonia

Abstract Background Plasma ammonia is commonly measured in the diagnostic evaluation of hospitalized newborns, but reference values are not well defined. Methods We prospectively enrolled newborns admitted to the level III/IV neonatal intensive care unit and level II intermediate special care nursery from January 2017 to January 2018. Infants with inborn errors of metabolism or liver disease were excluded. Plasma ammonia concentrations were measured once within the first week of life and evaluated by sex, gestational age, timing of the draw, blood collection method, and type of nutrition. Reference intervals were calculated. Results 127 neonates were included; one third (34%) were term infants born at ≥37 weeks gestation, and two thirds (66%) were born preterm at &lt;37 weeks gestation. Median plasma ammonia concentrations were 32 μmol/L (range &lt;10 to 86 μmol/L). Median ammonia concentrations were higher among preterm compared to term infants (35 vs. 28 μmol/L, p = 0.0119), and term female compared to term male infants (34 vs. 26 μmol/L, p = 0.0228). There was no difference in median ammonia concentrations between female and male preterm infants, based on gestational age within the preterm group, timing of the blood draw, presence of hyperbilirubinemia, blood collection method, or type of nutritional intake. Conclusions Plasma ammonia concentrations among newborns are higher than the expected adult concentrations and may vary by gestational age and sex. Blood collection method, type of nutrition, hyperbilirubinemia, and timing of the draw do not impact concentrations. We propose a reference limit of ≤82 μmol/L for newborns less than one week of age.

scholarly journals INTRAUTERINE GROWTH AND THE VITAMIN E STATUS OF FULL-TERM AND PRETERM NEWBORNS

2019 ◽  
Vol 37 (3) ◽  
pp. 291-296 ◽  
Author(s):  
Alyne Batista da Silva ◽  
Jeane Franco Pires Medeiros ◽  
Mayara Santa Rosa Lima ◽  
Amanda Michelly Braga da Mata ◽  
Eva Débora de Oliveira Andrade ◽  
...  
Keyword(s):  
Vitamin E ◽  
Umbilical Cord ◽  
Gestational Age ◽  
Full Term ◽  
Alpha Tocopherol ◽  
Term Infants ◽  
Intrauterine Growth ◽  
Cord Serum ◽  
Low Levels ◽  
Gestational Age At Birth

ABSTRACT Objective: To determine the concentration of alpha-tocopherol in umbilical cord serum of full-term and preterm newborns, in order to assess the nutritional status of both groups in relation to the vitamin and its possible correlation with intrauterine growth. Methods: A cross-sectional observational study conducted with 140 newborns, of which 64 were preterm and 76 were full-term. They did not have any malformations, they came from healthy mothers, who were nonsmokers, and delivered a single baby. Intrauterine growth was evaluated by weight-to-gestational age at birth, using Intergrowth-21st. Thealpha-tocopherol levels of umbilical cord serum were analyzed by High Performance Liquid Chromatography. Results: The mean concentration of alpha-tocopherol in umbilical cord serum for preterm and full-term infants was 263.3±129.5 and 247.0±147.6 µg/dL (p=0.494). In the preterm group, 23% were small for gestational age, whereas in the full-term group, this percentage was only 7% (p=0.017). Low levels of vitamin E were found in 95.3% of preterm infants and 92.1% of full-term infants. There was no correlation between alpha-tocopherol levels and weight to gestational age Z score (p=0.951). Conclusions: No association was found between alpha-tocopherol levels and weight to gestational age at birth. Intrauterine growth restriction was more frequent in preterm infants and most infants had low levels of vitamin E at the time of delivery.

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