BODY WATER COMPARTMENTS IN THE PREMATURE INFANT, WITH SPECIAL REFERENCE TO THE EFFECTS OF THE RESPIRATORY DISTRESS SYNDROME AND OF MATERNAL DIABETES AND TOXEMIA

PEDIATRICS ◽  
1962 ◽  
Vol 29 (6) ◽  
pp. 883-889
Author(s):  
Wesley M. Clapp ◽  
L. Joseph Butterfield ◽  
Donough O'Brien

Normal values for both total body water and extracellular water have been determined in 86 premature infants aged 1 to 90 days and weighing 940 to 2,435 gm, with use of the techniques of deuterium oxide and bromide dilution. Nine full-term infants aged 1 to 6 days and weighing 2,590 to 4,985 gm were similarly studied. Nine infants with the respiratory distress syndrome and eight infants of toxemic mothers studied in the first 24 hours of life showed no significant difference in their body water compartments in comparison to a control group of normal infants matched for age and weight. Seven infants of diabetic mothers studied in the first 24 hours of life showed a significant decrease in total body water, expressed as percentage of body weight, with a normal intracellular to extracellular water ratio. These data indirectly support other evidence that there is an increase in body fat in these infants at birth. See Table in the PDF file

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Anna Matyjek ◽  
Aleksandra Rymarz ◽  
Stanisław Niemczyk

Abstract Background and Aims One of the major symptoms of severe nephrotic syndrome is fluid retention. Fluid overload can induce cardiovascular damage. NT-proBNP (N-terminal pro-brain natriuretic peptide) and hsTnT (high sensitivity troponin T) are well known markers of this disorder. The aim of the study was to evaluate the association between volumes of body water compartments and markers of cardiovascular damage in patients with severe nephrotic syndrome (SNS) defined as nephrotic range proteinuria and hypalbuminaemia ≤ 2.5 g/dl. Method 40 patients with SNS and eGFR >30 ml/min/1.73m2 formed the study group (SNSG) and 40 healthy volunteers without SNS matched according to age, sex, height, body mass and kidney function formed the control group (CG). In all participants serum creatinine, serum albumin concentration, daily proteinuria, hsTnT and NT-proBNP were measured. Body water compartments such as extracellular water (ECW), intracellular water (ICW), total body water (TBW), overhydration (OH) were assessed using Body Composition Monitor, Fresenius Medical Care. For statistical analysis Spearman’s correlation coefficients, chi2 or Mann-Whitney U tests were used (Statistica v 13.1). Results SNSG included 28 males (70%) and 12 females. Median age was 55 years (IQR 30-65), the mean daily proteinuria was 10.5 ±5.0 g. The characteristics of the study parameters in two groups are described in the table. Significantly higher hsTnT (18 vs 6 ng/l, p=0.0001) and NT-proBNP (294.8 vs 47.1 pg/ml, p=0.0003) levels were observed in the severe nephrotic syndrome group in comparison (SNSG) to CG. In SNSG extracellular water was significantly higher (20.9 ±5,2 vs 17.4 ±3.3 L, p=0.001) and intracellular water (ICW) was significantly lower (18.9 ±5.2 vs 21.4 ±4.8 L, p=0.034) in comparison to CG. Interestingly total body water (TBW) did not differ between the groups (39.8 ±8.6 vs 38.8 ±7.7 L, p=0.603). Also overhydration which is a derivative of ECW, was higher in SNSG (OH: 4.2 vs 0.3 L, p<0.0001) than in CG. Significant, positive correlation was observed between OH and NT-proBNP (R=0.56, p<0.0001) as well as hsTnT (R=0.60, p<0.0001). We did not observed significant correlation between ECW and NT-proBNP or hsTnT. Conclusion In the severe nephrotic syndrome group fluid retention was associated with the increase in ECW and the decrease in ICW whereas TBW was the same in both groups. Such constellation can indicate for intracellular underhydration which was not describe so far. Overhydration, which is a derivative of ECW, positively correlated with markers of cardiovascular damage and can be important for patients with resistant SNS and can influence their prognosis.


PEDIATRICS ◽  
1961 ◽  
Vol 28 (2) ◽  
pp. 169-181
Author(s):  
B. Friis-Hansen

During growth of infants and children, certain characteristic changes are found. A rapid decrease of the relative volumes of total body water and of extracellular water occurs during the first year of life, followed by a smaller decrease of volume of extracellular water later in childhood. At the same time an increased heterogeneity of the extracellular water takes place. On the other hand, the volume of intracellular water increases a little during the first months of life and remains more or less constant from then on. Formulas and nomograms from which these body water compartments can be predicted are presented. Finally, data on the corresponding changes in the total body water and in body specific gravity are discussed.


2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Yong Yang ◽  
Wenkang Yan ◽  
Minyi Ruan ◽  
Lan Zhang ◽  
Jinzhen Su ◽  
...  

Abstract Background Lung recruitment is a maneuver used to decrease the length of intubation in preterm neonates. This study aimed to compare the therapeutic efficacy of lung recruitment plus intubation-surfactant-extubation (INSURE) procedure and INSURE alone for the preterm neonates with respiratory distress syndrome. Methods From 2017 to 2019, 184 preterm neonates (gestational age 24–32 weeks) with respiratory distress syndrome were enrolled and randomized into the lung recruitment group receiving lung recruitment (25 cm H2O, 15 s) plus INSURE and the control group receiving INSURE only. The primary outcome was the need for mechanical ventilation (MV) within 72 h after extubation. The secondary outcomes included duration of MV, noninvasive ventilation, total oxygen therapy, hospitalization time, and complications. Results Compared to the control group, the lung recruitment group had a significantly lower proportion of preterm neonates requiring MV within 72 h after extubation (23% vs. 38%, P = 0.025) and pulmonary surfactant administration, as well as a shorter MV duration. There was no significant difference in the incidences of complications (all P > 0.05) and in-hospital mortality (2% vs. 4%, P = 0.4) between the lung recruitment group and control group. Multivariate logistic regression analysis demonstrated that the control group had a 2.17-time higher risk of requiring MV than the lung recruitment group (AOR: 2.17, 95% CI: 1.13–4.18; P = 0.021). Compared with infants with a normotensive mother, infants with a hypertensive mother have a 2.41-time higher risk of requiring MV (AOR: 2.41, 95% CI: 1.15–5.05; P = 0.020). Conclusion Lung recruitment plus INSURE can reduce the need for MV within 72 h after extubation and did not increase the incidence of complications and mortality. Trial registration Chinese Clinical Trial Registry ChiCTR1800020125, retrospectively registered on December 15, 2018.


2020 ◽  
Author(s):  
Young Jin Kim ◽  
Byoung Kook Kim ◽  
Yong Hyuk Kim

Abstract Background: Various hormones are known to influence the production and secretion of pulmonary surfactant. But the relationship between respiratory distress syndrome (RDS) and thyroid hormone has yet to be clarified. Methods: 126 infants with gestational age between 24 and 34 weeks who were hospitalized at the neonatal ICU of the Wonju Severance Christian Hospital from April 2017 to February 2019 were included in the study. Infants were divided into 3 groups by gestational age – 24 weeks 0 days to 28 weeks 0 days, 28 weeks 0 days to 31 weeks 0 days, and 31 weeks 0 days to 33 weeks 0 days, each with 18, 34, and 74 subjects, respectively. Among the subjects, there were 56 infants with RDS and 70 infants without RDS.Results: The group with lowest gestational age showed T3 and fT4 level that was lower than those of other groups (p<0.05) on the day of birth but there was no difference in the TSH level (p=0.129). T3 and TSH level were lower in the RDS group compared with the control group on the day of birth (p<0.05). Free thyroxine (fT4) level was higher in the control group on the day of birth but without any significant difference. Multiple logistic regression analysis showed that lower serum TSH levels on the day of birth was associated with a higher incidence of RDS (p<0.05).Conclusion: The incidence of RDS was significantly higher in infants with lower serum TSH levels at birth, but there was no significant difference in RDS incidence according to serum thyroid hormone levels.


1997 ◽  
Vol 82 (3) ◽  
pp. 907-911 ◽  
Author(s):  
Wouter D. van Marken Lichtenbelt ◽  
Yvonne E. M. Snel ◽  
Robert-Jan M. Brummer ◽  
Hans P. F. Koppeschaar

Abstract GH has a strong influence on body composition. However, the effects of GH deficiency in adults on water compartments are not well understood. Therefore, extracellular water (ECW) and total body water were independently determined by deuterium and bromide dilution and by bioimpedance spectrometry in GH-deficient (GHD) adults and compared to those in controls, matched for age, sex, body weight, and height. The results show that the percent body fat was significantly (P &lt; 0.05) higher, and total body water and intracellular water (ICW) were significantly lower in GHD adults for males, females, and both sexes combined. ECW was not significantly different between the two groups. ECW/ICW in GHD adults (0.42 ± 0.03) was significantly (P &lt; 0.01) higher than that in controls (0.39 ± 0.02). There was a significant positive relation between the ECW/ICW ratio and the percent body fat. These results were confirmed by the bioimpedance spectrometry measurements.


2021 ◽  
Vol 35 ◽  
pp. 205873842110005
Author(s):  
Mohamed Shawky Elfarargy ◽  
Ghada M Al-Ashmawy ◽  
Sally Abu-Risha ◽  
Haidy Khattab

Neonatal Respiratory Distress Syndrome (RDS) and Transient Tachypnea of newborn (TTN) are common similar neonatal respiratory diseases. Study the early predictor markers in differentiation between TTN and RDS in neonates. A prospective case control study which was done in Neonatal Intensive Care Unit (NICU) of Tanta University Hospital (TUH) from September 2016 to March 2018. Three groups of neonates were included in the study: RDS group (45 neonates), TTN group (45 neonates), and control group (45 healthy neonates). There were statistically significant difference (SSD) between our studied three groups as regard serum Malondialdehyde (MDA), Superoxide dismutase SOD, Lactate dehydrogenase (LDH), and blood PH and P-values were 0.001* for these comparative parameters. The ROC curve of RDS cases revealed that the serum MDA Cut off, sensitivity and specificity were 1.87 mmol/L, 98%, 96%, respectively which had the highest sensitivity and specificity followed by the serum SOD then the serum LDH and lastly the blood PH while in TTN cases, the serum MDA Cut off, sensitivity and specificity were 0.74 mmol/L, 96%, 93%, respectively then the serum SOD then the serum LDH and lastly the blood PH. Serum MDA, SOD, LDH, and PH had a beneficial role as early predictors in differentiation between TTN and RDS in neonates.


1995 ◽  
Vol 73 (3) ◽  
pp. 349-358 ◽  
Author(s):  
Paul Deurenberg ◽  
Anna Tagliabue ◽  
Frans J. M. Schouten

The relationship between total body water (TBW) and extracellular water (ECW), measured by deuterium oxide dilution and bromide dilution respectively, and impedance and impedance index (height2/impedance) at 1, 5, 50 and 100 kHz was studied. After correction for TBW, ECW was correlated only with the impedance index at 1 and 5 kHz. After correction for ECW, TBW was best correlated with the impedance index at 100 kHz. The correlation of body-water compartments with impedance values obtained with modelling programs was lower than with measured impedance values. Prediction formulas for ECW (at 1 and 5 kHz) and TBW (at 50 and 100 kHz) were developed. The prediction errors for ECW and TBW were 1·0 and 1·7 kg respectively (coefficient of variation 5%). The residuals of both ECW and TBW were related to the ECW/TBW value. Application of the prediction formulas in a population, independently measured, revealed a slight overestimation of TBW and ECW, which could be largely explained by differences in the validation group in body-water distribution and in body builds. The ratio of impedance at 1 kHz to impedance at 100 kHz was correlated with body-water distribution (ECW/TBW). The relation is however not strong enough to be useful as a predictor. It is concluded that an independent prediction of ECW and TBW, using impedance at low and high frequency respectively, is possible, but that the bias depends on the body-water distribution and body build of the measured subject.


Author(s):  
Mohamed Shawky Elfarargy ◽  
Sally Abu-Risha ◽  
Ghada Al-Ashmawy ◽  
Haidy Khattab

Background: Neonatal respiratory distress syndrome (RDS) is a very important dangerous disease in neonates and is accompanied by neonatal complications and death. Patients and Methods: A case-control study, with the identification number TCTR20210206001 was done on 100 neonates who were admitted to the neonatal intensive care unit (NICU) of Tanta University Hospital (TUH) suffering from RDS (patient group) and 100 healthy neonates (control group). Estimation of serum vitamin A (retinol) was occurred for all neonates of this study within the first four hours after birth before any nutrition or therapies. Results: Showed no significant difference between serums retinol (RT) levels in grade 1&2 RDS neonates (patient group) and the serum RT levels in the control group while there was significant difference between serums retinol levels in grade 3&4 RDS neonates (patient group) and the serum retinol levels in the control group where the P-value was 0.006, 0.002 respectively. Conclusion : Serum vitamin A levels in neonates were decreased in RDS neonates and could be used as a predictor for the development and severity of RDS. Recommendation: Routine estimation of serum vitamin A levels in neonates as a novel predictor for neonatal RDS.


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