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The bioavailabilty of selenium (Se) from selenium-rich Spirulina (SeSp) was assessed in Se-deficient rats by measuring tissue Se accumulation and glutathione peroxidase (GSH-Px) activity. For 42 d, rats were subjected to dietary Se depletion by consumption of a Torula yeast (TY)-based diet with no Se; controls were fed the same diet supplemented with 75 microg Se/kg diet as sodium selenite. Se-deficient rats were then repleted with Se (75 microg/kg) by the addition of sodium selenite, selenomethionine (SeMet) or SeSp to the TY basal diet. Selenium speciation in SeSp emphasized the quasi-absence of selenite (2% of total Se); organic Se comprised SeMet (approximately 18%), with the majority present in the form of two selenoproteins (20-30 kDa and 80 kDa). Gross absorption of Se from SeSp was significantly lower than from free SeMet and sodium selenite. SeMet was less effective than sodium selenite in restoring Se concentration in the liver but not in kidney. SeSp was always much less effective. Similarly, Se from SeSp was less effective than the other forms of Se in restoring GSH-Px activity, except in plasma and red blood cells where no differences were noted among the three sources. This was confirmed by measuring the bioavailability of Se by slope-ratio analysis using selenite as the reference form of Se. Although Se from SeSp did not replenish Se concentration and GSH-Px activity in most tissues to the same degree as the other forms of Se, we conclude that it is biologically useful and differently metabolized due to its chemical form.

Neonatal abstinence syndrome has become a growing concern in infants born to substance-abusing mothers in the State of Florida. At Sarasota Memorial Hospital in Sarasota, FL, methadone and morphine treatment strategies have been formulated to manage symptomatic neonates after birth. We report our findings over a 5-year period utilizing each of these protocols in a community hospital setting.

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Background. Optimal nutrition for very low birth weight (VLBW, <1500 grams) preterm infants is critical in the neonatal period. With substantial variation in clinical practice, there is limited data on impact of early nutrition on growth and outcomes. Objective. The purpose of this study was to conduct a quality improvement project evaluating growth and clinical outcomes after implementing standardized enteral feeding guidelines for preterm infants. Methods. Evidence based clinical practice feeding guidelines were developed and implemented for VLBW infants in NICU. Primary outcome measures were (1) the rate of early initiation of enteral feeds (< 5 days of life) and (2) growth outcomes as measured by weight and head circumference from birth to discharge. Secondary outcome measures were total TPN days and rate of cholestasis. Retrospective data prior to initiation of guidelines were compared with data from post-implementation period in logistic and linear regression models. Results. Pre and post-implementation cohorts consisted of 121 and 114 VLBW infants respectively. Standardized guidelines resulted in early initiation of enteral feeds by day 5 (OR = 3.57; p< 0.001) and an average weight gain >20gm/day during hospital stay (OR= 1.89; p< 0.05). In both groups there was early achievement of full feeds with early initiation of feeds (p<0.001). Similarly, infants who initiated early enteral feeds were less likely to develop cholestasis (direct bilirubin >2 mg/ dl) (p<0.01) Conclusions. Consistent and standardized approach to early nutrition in VLBW infants results in improved growth and clinical outcomes with less duration of TPN and decreased rate of cholestasis.

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Simmons), O e m e d m Utah, S a l t Lake C i t y , UT. Laser doppler (LD) velocimetry theoretically offers a noninvasive objective measurement of tissue perfusion, an important The f i r s t o b j e c t i v e o f t h i s study was t o determine i f leakageclinical parameter that is currently only subjectively assessed.(i) through a pneumothorax and chest tube o f i n f a n t s w i t hThe laser doppler (Med Pacific)uses a skin sensor to measure pulmonary disease i s l e s s d u r i n g h i g h frequency j e t v e n t i l a t i o n .reflected light from a helium-neon laser that penetrates tissue (HFJV) than during conventional v e n t i l a t i o n (CV). We measured V about 15 mm over a 1 mm2 area. It utilizes the doppler i n 5 i n f a n t s , who had chest tubes placed t o r e l i e v e tension principle to calculate the rootmean-square frequency of the pneumothoraces w h i l e managed a l t e r n a t e l y on CV and HFJV. I n a l l reflected light. Because of the extremely small cross sectional area of the vessels in the microcirculation that this technique i n f a n t s , 0 was less during HFJV than CV (49+26 vs 1 5 7~8 1 ml/min, samples, this continuously monitored number represents changes in meantSE). However, we a l s o n o t i c e d t h a t s i g n i f i c a n t l y lower tissue blood flow. We used the LD to assess tissue perfusion on mean tracheal airway pressure ( P t m ) were used d u r i n g HFJV than 10 critically ill neonates (480 to 1600 gm) in the NICU to CV ( 9 i l vs 15' 2 cm H 0, p<0.01). PaCO was also l e s s (35+8 V S evaluate the feasibility of its clinical application. During the 45'9 mmHg; p<0.03) a?though Pa0 valueg were n o t s i g n i f i c a n t l y study we recorded temperature, heart rate, blood pressure and d i f f e r e n t . W e then turned t o a6 animal model o f RDS t ohematocrit to determine what factors might influence perfusion.determine t h e e f f e c t s o f PtCJ and mode o f v e n t i l a t i o n on \j. I nWe monitored the infants during procedures that were stressful or would alter cardiac output such as ET tube suctioning, blood 9 s a l i n e lavaged cats we induced pneumothoraces by a p p l i c a t i o n transfusion and intubation. The LD was very sensitive, in fact, o f h i g h airway pressures. F i r s t we adjusted CV and HFJV too sensitive to changes in tissue blood flow. There was no s e t t i n g s so t h a t P t X was lower d u r i n g HFJV; we then adjusted correlation between any of our measured parameters and changes iu t h e v e n t i l a t o r s t o produce s i m i l a r P t G . When Pt% was lowered perfusion as measured by the LD. Obvious stress with procedures from 13'0.3 (CV) t o 10i0.5 cm H 0 (HJFV), V decreased such as suctioning and intubation caused immediate decreases in s i g n i f i c a n t l y (p<0.01) from 651286 t o 2?4+84 mllmin. When PtCJ perfusion, but changes in the readings from minute to minute was h e l d constant (12.7'1 cm H 0 ) mean V values were i d e n t i c a l varied just as much. In fact, moving the skin sensor as little as 1 mm'w...