RESPONSE OF THE NEWBORN INFANT TO MAJOR SURGERY

PEDIATRICS ◽  
1959 ◽  
Vol 23 (6) ◽  
pp. 1063-1084
Author(s):  
Eleanor Colle ◽  
Elsa Proehl Paulsen
Keyword(s):  
Urinary Excretion ◽  
Potassium Chloride ◽  
Newborn Infant ◽  
Renal Excretion ◽  
Newborn Infants ◽  
Relative Magnitude ◽  
Postoperative Management ◽  
Major Surgery ◽  
Sodium Potassium ◽  
Diminished Capacity

Balance data for sodium, potassium, chloride, nitrogen, and water were obtained postoperatively in 15 newborn infants operated upon in the first 4 days of life and in 5 control newborn infants. The infants showed a response in terms of electrolyte and water balances which is significantly different from that reported in adults: The volumes of urine were equal to or greater than those in normal infants of a comparable age. The data suggest a diminished capacity of the newborn to conserve water postoperatively, but a normal capacity to dilute the urine. No evidence of retention of water was observed. The urinary excretion of sodium and chloride was equal to or larger than that of normal infants. The infants who had losses postoperatively from gastrointestinal suction showed no capacity to reduce renal excretion of these ions while they suffered these large extrarenal losses. The concentrations of sodium and chloride in the serum remained normal or became slightly elevated postoperatively. Losses of potassium and nitrogen in the urine were of the same relative magnitude as those in adults. The observed responses are discussed in terms of the function of antidiuretic and adrenocortical hormones in the newborn infant. The application of these data to practical considerations of fluid and electrolyte therapy in the postoperative management of the newborn infant are discussed briefly.

scholarly journals Adrenocortical steroids increase renal thiazide diuretic receptor density and response.

1994 ◽  
Vol 5 (6) ◽  
pp. 1361-1368
Author(s):  
Z Chen ◽  
D A Vaughn ◽  
P Blakely ◽  
D D Fanestil
Keyword(s):  
Potassium Chloride ◽  
Normal Level ◽  
Thiazide Diuretic ◽  
Renal Excretion ◽  
Specific Binding ◽  
Dose Range ◽  
High Dose ◽  
Receptor Density ◽  
Sodium Potassium ◽  
Thymus Weight

The density of the rat renal pharmacologic receptor for thiazide-type diuretics, as quantitated by the maximal specific binding of (3H)metolazone, decreased to one-third normal after adrenalectomy. Selective glucocorticoid (dexamethasone or RU-28362) replacement increased thiazide receptor density to or above the normal level over the dose range of steroid that decreased thymus weight, which served as a bioassay for glucocorticoid activity. Mineralocorticoid (fludrocortisone or aldosterone), in doses that did not decrease thymus weight, also increased thiazide diuretic receptor density to or above normal. The addition of glucocorticoid (RU-28362) to maximal aldosterone increased thiazide receptor above that produced by aldosterone alone and to threefold normal. Similarly, the addition of aldosterone to high-dose RU-28362 also increased thiazide receptor density above that produced by the glucocorticoid alone and to threefold normal. Hence, the effects of glucocorticoids and mineralocorticoids appeared to be additive. The increase in renal thiazide receptor density produced by fludrocortisone, at a dose that elicited both mineralocorticoid and glucocorticoid effects, was unrelated to the basal (prethiazide) renal excretion of sodium, potassium, chloride, or calcium. However, fludrocortisone-pretreated animals responded to bendroflumethiazide with a greater natriuresis than did controls. In addition, the magnitudes of the thiazide-elicited natriuresis and chloriuresis correlated significantly with thiazide receptor. It was concluded that both the density of the renal thiazide receptor and the quantity of sodium and chloride reabsorbed by the thiazide-sensitive Na-Cl cotransporter in the kidney are under adrenocortical regulation.

The Platelet of the Newborn Infant – Adenine Nucleotide Metabolism and Release

1980 ◽  
Vol 43 (02) ◽  
pp. 099-103 ◽  
Author(s):  
J M Whaun ◽  
P Lievaart ◽  
Keyword(s):  
Newborn Infant ◽  
Adenine Nucleotide ◽  
Platelet Rich Plasma ◽  
Adenine Nucleotides ◽  
Newborn Infants ◽  
Specific Radioactivity ◽  
Nucleotide Metabolism ◽  
Breakdown Product ◽  
Term Infants ◽  
Adenine Nucleotide Metabolism

SummaryBlood from normal full term infants, mothers and normal adults was collected in citrate. Citrated platelet-rich plasma was prelabelled with 3H-adenine and reacted with release inducers, collagen and adrenaline. Adenine nucleotide metabolism, total adenine nucleotide levels and changes in sizes of these pools were determined in platelets from these three groups of subjects.At rest, the platelet of the newborn infant, compared to that of the mother and normal adult, possessed similar amounts of adenosine triphosphate (ATP), 4.6 ± 0.2 (SD), 5.0 ± 1.1, 4.9 ± 0.6 µmoles ATP/1011 platelets respectively, and adenosine diphosphate (ADP), 2.4 ± 0.7, 2.8 ± 0.6, 3.0 ± 0.3 umoles ADP/1011 platelets respectively. However the marked elevation of specific radioactivity of ADP and ATP in these resting platelets indicated the platelet of the neonate has decreased adenine nucleotide stores.In addition to these decreased stores of adenine nucleotides, infant platelets showed significantly impaired release of ADP and ATP on exposure to collagen. The release of ADP in infants, mothers, and other adults was 0.9 ± 0.5 (SD), 1.5 ± 0.5, 1.5 ± 0.1 umoles/1011 platelets respectively; that of ATP was 0.6 ± 0.3, 1.0 ± 0.1,1.3 ± 0.2 µmoles/1011 platelets respectively. With collagen-induced release, platelets of newborn infants compared to those of other subjects showed only slight increased specific radioactivities of adenine nucleotides over basal levels. The content of metabolic hypoxanthine, a breakdown product of adenine nucleotides, increased in both platelets and plasma in all subjects studied.In contrast, with adrenaline as release inducer, the platelets of the newborn infant showed no adenine nucleotide release, no change in total ATP and level of radioactive hypoxanthine, and minimal change in total ADP. The reason for this decreased adrenaline reactivity of infant platelets compared to reactivity of adult platelets is unknown.Infant platelets may have different membranes, with resulting differences in regulation of cellular processes, or alternatively, may be refractory to catecholamines because of elevated levels of circulating catecholamines in the newborn period.

Oxygen Consumption in Platelets of Newborn Infants before and after Stimulation by Thrombin.

1976 ◽  
Vol 35 (03) ◽  
pp. 712-716 ◽  
Author(s):  
D. Del Principe ◽  
G Mancuso ◽  
A Menichelli ◽  
G Maretto ◽  
G Sabetta
Keyword(s):  
Oxygen Consumption ◽  
Cord Blood ◽  
Umbilical Cord ◽  
Newborn Infant ◽  
Umbilical Cord Blood ◽  
Newborn Infants ◽  
O2 Consumption ◽  
Adult Control ◽  
Healthy Newborn ◽  
Before And After

SummaryThe authors compared the oxygen consumption in platelets from the umbilical cord blood of 36 healthy newborn infants with that of 27 adult subjects, before and after thrombin addition (1.67 U/ml). Oxygen consumption at rest was 6 mμmol/109/min in adult control platelets and 5.26 in newborn infants. The burst in oxygen consumption after thrombin addition was 26.30 mμmol/109/min in adults and 24.90 in infants. Dinitrophenol did not inhibit the burst of O2 consumption in platelets in 8 out of 10 newborn infants, while the same concentration caused a decrease in 9 out of 10 adult subjects. Deoxyglucose inhibited the burst in O2 consumption in newborn infant and adult platelets by about 50%. KCN at the concentration of 10−4 M completely inhibited basal oxygen consumption but did not completely inhibit the burst after thrombin. At the concentration of 10−3 M, it inhibited both basal O2 consumption and the burst in infants and adult subjects.

SOME EFFECTS OF PERCHLORATE ON THE DISTRIBUTION OF 131-IODIDE

1965 ◽  
Vol 50 (2) ◽  
pp. 195-201 ◽  
Author(s):  
E. Schönbaum ◽  
E. A. Sellers ◽  
M.J. Gill
Keyword(s):  
Urinary Excretion ◽  
Renal Excretion ◽  
Kidney Tissue ◽  
Intraperitoneal Dose ◽  
Blood Radioactivity ◽  
Radioactivity Levels

ABSTRACT The distribution of an intraperitoneal dose of 131-iodide was studied in rats receiving perchlorate. The accumulation of radioactivity in the stomach, which occurred soon after injection in controls, was inhibited by perchlorate. Concurrent with this, radioactivity in blood was higher in perchlorate treated rats than in controls. After perchlorate, more radioactivity in kidney tissue and an elevated urinary excretion of the tracer was noted. After 24 hours, plasma radioactivity was lower in perchlorate treated rats than in controls. Increased renal excretion of 131I after perchlorate is, at least in part, due to higher blood radioactivity levels, probably because of decreased iodide space due to the action of perchlorate.

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