SPONTANEOUS ALVEOLAR RUPTURE AT BIRTH

PEDIATRICS ◽  
1963 ◽  
Vol 32 (5) ◽  
pp. 816-824 ◽  
Author(s):  
Victor Chernick ◽  
Mary Ellen Avery
Keyword(s):  
Newborn Infant ◽  
Spontaneous Pneumothorax ◽  
Pleural Cavity ◽  
Fold Increase ◽  
Foreign Material ◽  
Newborn Period ◽  
Term Infants ◽  
Oxygen Breathing ◽  
Rate Of Absorption ◽  
Principles Of Treatment

Spontaneous pneumothorax in the newborn period was recognized in fifteen infants over a 6-year period. Seven of the 15 infants were symptomatic in the delivery room, which suggests that lung rupture occurred with the first few breaths. Three of the seven were meconium stained. The remaining eight infants were symptomatic within the first 24 hours. The unique features of the first breath of the newborn infant, namely, the serial opening of ventilatory units and high applied pressures, suggest that any foreign material in the airway would make rupture of opened units likely. Studies on the inflation of airless lungs demonstrate the opening phenomenon. Four of the 15 infants died, 2 from their pneumothoraces. This bad experience led us to examine principles of treatment of spontaneous pneumothorax with the recommendation that oxygen breathing in some term infants, and prompt aspiration in others would be useful. The majority, however, can be expected to resolve spontaneously. Measurements of the rate of absorption of air in the pleural cavity in the rabbit show a six-fold increase with 100% O2 breathing.

RECOGNITION OF SPONTANEOUS PNEUMOTHORAX IN PREMATURE INFANTS

PEDIATRICS ◽  
1959 ◽  
Vol 24 (6) ◽  
pp. 996-1004
Author(s):  
Lula O. Lubchenco
Keyword(s):  
Birth Weight ◽  
Respiratory Distress ◽  
Premature Infants ◽  
Spontaneous Pneumothorax ◽  
Neonatal Period ◽  
Age At Onset ◽  
Newborn Period ◽  
Term Infants ◽  
Clinical Records ◽  
Respiratory Embarrassment

An analysis of the clinical records of 27 infants who developed spontaneous pneumothorax in the neonatal period is presented; 17 (63%) were premature infants. The age at onset of the disease varied with the birth weight. The infants with birth weights of 1,500 grams or less averaged 24 days of age at the onset of spontaneous pneumothorax, and the full-term infants developed the disease in the immediate newborn period. The diagnosis of spontaneous pneumothorax was suspected when symptoms of respiratory distress alternated with unusual activity, with an increase of symptoms when the infant was fed or removed from oxygen. The immature infant showed cyanosis or apneic spells, alternating with alertness or apparent hunger. The more mature infant manifested greater respiratory distress and greater activity. The activity assumed the form of irritability, restlessness and, at times, opisthotonus. These symptoms were considered to be due to a persistent lowgrade hypoxia caused by the pneumothorax rather than being manifestations of a vigorous, healthy infant. Signs of infection were minimal or absent. The importance of roentgenograms in establishing the diagnosis is emphasized. Treatment should include relief of hypoxia by administration of oxygen in low concentration and prevention of acute respiratory embarrassment due to distention of the stomach by feedings. Removal of air from the pneumothorax or pneumomediastinum is necessary in severe cases.

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.

scholarly journals Neonatal and Postneonatal Pulmonary Hypertension

Children ◽  
2021 ◽  
Vol 8 (2) ◽  
pp. 131
Author(s):  
Satyan Lakshminrusimha
Keyword(s):  
Pulmonary Hypertension ◽  
Preterm Infants ◽  
Ductus Arteriosus ◽  
Right Ventricular Dysfunction ◽  
Fold Increase ◽  
Pulmonary Vein Stenosis ◽  
Term Infants ◽  
Pulmonary Vasodilators ◽  
Non Invasive Ventilation ◽  
Early Closure

During transition at birth with ventilation of the lungs, pulmonary vascular resistance (PVR) decreases from high fetal values, leading to an 8 to 10-fold increase in pulmonary blood flow (Qp). In some infants, this transition does not occur, resulting in pulmonary hypertension (PH). In infants, PH can present as: (a) primary PH in term neonates (idiopathic), (b) PH secondary to lung disease or hypoplasia in term infants, (c) acute PH in preterm infants with respiratory distress syndrome (RDS), (d) chronic PH with bronchopulmonary dysplasia (BPD) in preterm infants and (e) post-neonatal PH. A hemodynamically significant patent ductus arteriosus (PDA) can exacerbate PH in preterm infants due to increased Qp. Pulmonary vein stenosis (PVS) can complicate BPD with PH. Diagnosis of PH is based on clinical features, echocardiography and, in some intractable cases, cardiac catheterization. Therapy of PH includes oxygen, invasive or non-invasive ventilation, correction of acidosis, surfactant and selective and non-selective pulmonary vasodilators such as inhaled nitric oxide and sildenafil, respectively. Early closure of a hemodynamically significant PDA has the potential to limit pulmonary vascular remodeling associated with BPD and PH. The role of thiamine in pathogenesis of PH is also discussed with the recent increase in thiamine-responsive acute pulmonary hypertension in early infancy. Recognition and prompt therapy of PH can prevent right ventricular dysfunction, uncoupling and failure.

scholarly journals 90 Vascular Responses to Oxygen Breathing in the Newborn Infant

1967 ◽  
Vol 1 (3) ◽  
pp. 223-223
Author(s):  
Nicholas M Nelson ◽  
Christopher H Nourse ◽  
Bettty L Priestley ◽  
Ruth B Cherry ◽  
Clement A Smith
Keyword(s):  
Newborn Infant ◽  
Vascular Responses ◽  
Oxygen Breathing

STUDIES OF THE IMMUNOLOGY OF THE NEWBORN INFANT

PEDIATRICS ◽  
1953 ◽  
Vol 12 (2) ◽  
pp. 151-157
Author(s):  
JOSEPH DANCIS ◽  
JOHN J. OSBORN ◽  
HANS W. KUNZ
Keyword(s):  
Antibody Response ◽  
Newborn Infant ◽  
Premature Infants ◽  
Single Injection ◽  
Diphtheria Toxoid ◽  
Birth Date ◽  
Term Infants ◽  
Normal Birth ◽  
Significant Difference

The antibody response of premature infants immunized at birth with a single injection of diphtheria toxoid was compared to that of a group of term infants similarly immunized. No significant difference was demonstrated. A group of premature infants was immunized about the time that was estimated to be their normal birth date and the antibody response compared to that of term infants at birth. The performance of the premature infants was superior to that of the term infants. The significance of these findings is discussed.

Isolated Phrenic Nerve Palsy in the Newborn

PEDIATRICS ◽  
1972 ◽  
Vol 49 (3) ◽  
pp. 449-451
Author(s):  
Barry T. Smith
Keyword(s):  
Differential Diagnosis ◽  
Respiratory Distress ◽  
Newborn Infant ◽  
Phrenic Nerve ◽  
Nerve Palsy ◽  
Forceps Delivery ◽  
Phrenic Nerve Palsy ◽  
Newborn Period ◽  
History Of

A case of isolated phrenic nerve palsy in a newborn infant following a difficult forceps delivery is described. Treatment was supportive and complete clinical and radiological recovery occurred between the tenth and eighteenth days of life. Phrenic nerve palsy should be considered in the differential diagnosis of respiratory distress in the newborn period, especially if there is a history of traumatic delivery or if a brachial palsy is present.

PHYSIOLOGIC HYPERBILIRUBINEMIA AND HEMOLYSIS OF ERYTHROCYTES BY HYDROGEN PEROXIDE SOLUTION IN THE NEWBORN: INVESTIGATION OF A POSSIBLE RELATIONSHIP

PEDIATRICS ◽  
1957 ◽  
Vol 20 (1) ◽  
pp. 92-97
Author(s):  
Jo-Anne E. Richards ◽  
Richard B. Goldbloom ◽  
Ronald L. Denton
Keyword(s):  
Hydrogen Peroxide ◽  
Statistical Analysis ◽  
Vitamin E ◽  
Clinical Significance ◽  
Newborn Infant ◽  
Newborn Infants ◽  
Control Group ◽  
Term Infants ◽  
Mean Values ◽  
Relative Deficiency

Forty-three full-term infants have been studied with respect to hemolysis of erythrocytes in solutions of hydrogen peroxide and concentrations of bilirubin in the serum. Mean values for concentration of bilirubin in the serum and percentage of hemolysis followed similar patterns in the first few days of life. However, statistical analysis of the data in individual cases showed no significant correlation between the degree of hemolysis in solutions of hydrogen peroxide and the concentrations of bilirubin in the serum. Administration of vitamin E prevented an increase in hemolysis of erythrocytes in solutions of hydrogen peroxide but failed to produce any significant change in concentrations of bilirubin as compared with the control group. The evidence suggests that the relative deficiency of vitamin E which exists in most newborn infants does not play a part in the causation or maintenance of physiologic hyperbilirubinemia. The clinical significance of increased hemolysis of the erythrocytes of the newborn infant in solutions of hydrogen peroxide remains a mystery. Possible approaches to the clarification of this problem are suggested.

scholarly journals A Randomized Double Blind Controlled Safety Trial Evaluating D-Lactic Acid Production in Healthy Infants Fed a Lactobacillus reuteri-containing Formula

2014 ◽  
Vol 7 ◽  
pp. NMI.S14113 ◽  
Author(s):  
Konstantinos Papagaroufalis ◽  
Aikaterini Fotiou ◽  
Delphine Egli ◽  
Liên-Anh Tran ◽  
Philippe Steenhout
Keyword(s):  
Lactic Acid ◽  
Treatment Effect ◽  
Lactobacillus Reuteri ◽  
Lactic Acid Production ◽  
Fold Increase ◽  
Primary Objective ◽  
Double Blind ◽  
Term Infants ◽  
Healthy Infants ◽  
Colony Forming Units

Background D-Lactic acidosis in infants fed lactic acid bacteria-containing products is a concern. Methods The primary objective of this non-inferiority trial was to compare urinary D-lactic acid concentrations during the first 28 days of life in infants fed formula containing Lactobacillus reuteri (1.2 x 106 colony forming units (CFU)/ml) with those fed a control formula. The non-inferiority margin was set at a two-fold increase in D-lactic acid (0.7 mmol/mol creatinine, log-transformed). Healthy term infants in Greece were enrolled between birth and 72 hours of age, and block randomized to a probiotic ( N = 44) or control ( N = 44) group. They were exclusively fed their formulae until 28 days of age and followed up at 7, 14, 28, 112, and 168 ± 3 days. Anthropometric measurements were taken at each visit and tolerance recorded until 112 days. Urine was collected before study formula intake and at all visits up to 112 days and blood at 14 days. Results D-Lactic acid concentration in the probiotic group was below the non-inferiority margin at 28 days: treatment effect -0.03 (95% confidence interval [CI]: [-0.48 to 0.41]) mmol/mol creatinine but was above the non-inferiority margin at 7 and 14 days–-treatment effect 0.50 (95% CI: [0.05-0.96]) mmol/mol creatinine and 0.45 (95% CI: [0.00-0.90]) mmol/mol creatinine, respectively. Blood acid excess and pH, anthropometry, tolerance, and adverse events (AEs) were not significantly different between groups. Conclusion Intake of L. reuteri-containing formula was safe and did not cause an increase in D-lactic acid beyond two weeks. Trial Registration ClinicalTrials.gov NCT01119170.

scholarly journals On traumatic pneumothorax with primary gas injection

2021 ◽  
Vol 30 (9) ◽  
pp. 891-894
Author(s):  
V. K. Sokolova
Keyword(s):  
Spontaneous Pneumothorax ◽  
Pleural Cavity ◽  
Gas Injection ◽  
Lung Parenchyma ◽  
Pathological Process ◽  
Tuberculosis Patients ◽  
Gas Accumulation ◽  
The Press ◽  
Artificial Pneumothorax ◽  
Traumatic Pneumothorax

Over the last 10-15 years, treatment of tuberculosis patients with artificial pneumothorax has become widespread and there are many works devoted to collapse therapy in the press; details of the technique, efficiency of treatment, and complications are discussed. Spontaneous pneumothorax (SP) is one of the most dangerous complications of pneumothorax. Under p. p. we understand gas accumulation in pleural cavity in case of lung perforation, as the result of pathological process in the lung, more often of subpleural cavernous cavity breakthrough, caseous focus, or due to lung parenchyma needle trauma while applying pneumothorax.

Complement in the Newborn Infant

PEDIATRICS ◽  
1979 ◽  
Vol 64 (5) ◽  
pp. 781-786
Author(s):  
Richard B. Johnston ◽  
Karl M. Altenburger ◽  
Alva W. Atkinson ◽  
Robert H. Curry
Keyword(s):  
Newborn Infant ◽  
Gestational Age ◽  
Hemolytic Activity ◽  
Alternative Pathway ◽  
Classical Pathway ◽  
Term Infants ◽  
Complement Components ◽  
Factor B ◽  
Serious Infection ◽  
Dual Pathway

Classical pathway activities and component concentrations in sera from newborns can be compared more realistically to normal adult values than to maternal values since activities and components are increased in maternal sera. Whole complement hemolytic activity appears to be subnormal in approximately half of term infants, with mean activity being about 70% to 90% of normal. Concentrations of Clq, C4, C2, C3, and C7 have been 60% to 100% of adult concentrations in term infants and somewhat less in preterm infants. Younger gestational age has been correlated with lower levels of total hemolytic activity, Clq, C4, and C3. Activity of the alternative pathway appears to be more frequently subnormal in newborn sera than does activity of the classical pathway. Factor B and properdin concentrations have varied from about 35% to 60% and 35% to 70% of adult values, respectively. Opsonization and hemolysis mediated by the alternative pathway have been subnormal in 15% to 75% of term infants, depending upon the assay. Gestational age appears to correlate with alternative pathway hernobytic activity and properdin concentration but not with concentration of factor B. Reductions such as these in single complement components and functions probably would not predispose an otherwise normal individual to infection. However, it seems likely that the multicomponent and dual pathway deficiencies found in neonates, especially in conjunction with the decreased phagocyte function known to exist in that population, could increase the likelihood of serious infection. Predicted infections with this configuration of abnormalities would be extracellular bacterial. Whether the newborn infant is actually predisposed to infection because of the complement deficiencies summarized here remains to be proved. This and other unanswered questions lead us to conclude that understanding of the complement system in the newborn is, pardon the expression, still in its infancy.

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