1264 Afterload Reduction by Sodium Nitroprussiate (Snp) in Asphyxiated Infants With Hypertension and Heart Failure

Abstract

Extreme similarities in the anatomy and physiology of the feto-placento-uterine unit in baboons and humans make the baboon an ideal model to investigate various aspects of reproductive physiology. Thirty-six amniotic fluid samples from 30 normal baboon pregnancies ranging in length from 50 to 173 days (term=180 days) were analyzed to obtain baseline data.Amniotic fluid volume as determined by para-aminohippurate dilution ranged from 126 to 380 ml, with a mean ( ' S D ) of 269'77.6 ml. Volume did not vary significantly over the period of the study. It correlated well with the volume determined at cesarean section by aspirating all the fluid prior to incising the uterus (r=0.65). Osmolality averaged 273'8.3 mOsm/kg (range:252-287). Creatinine (C) concentration ranged from 0.23 to 1.51 mg/dl and increased linearly with gestational length (G): C=0.008 G0.09, r=0.63, Syx=0.248. Protein (P) concentration ranged from 0.022 to 1.229 g/dl and increased as a power function of gestational length: P=0.022 G'. ~, r=0.88,. A spectrophotometric absorption peak was identified at 400 nm rather than at 450 nm: AOD400 averaged 0.047 '0.0686 (range: 0-0.290) and did not vary with gestational length.While these values are of the same order of magnitude as those observed in human amniotic fluid, the data suggest that baboon amniotic fluid differs from humans' in a number of respects.NEONATAL EFFECTS OF SEVERE MATERNAL HYPERTENSION BEFORE 36 WEEKS GESTATION Jane E Braz V i r i n i a 1260 L i t t l e , Jud Grimm (Spon, d i y j T k iUniversity M m cent&, Dept. o f Pediatrics, Durham, NC. Neonatal problems associated w i t h an abnormal f e t a l environment have been well documented f o r i n f a n t s o f d i a b e t i c mothers, b u t the e f f e c t s o f severe hypertension upon the i n f a n t have n o t been w e l l defined. Twenty-eight i n f a n t s 27-35 weeks o f gestation, delivered o f mothers w i t h d i a s t o l i c hypertension 2 110 mmHg (IHM) and 28 gestational age-matched control i n f a n t s (C1)'delivered o f normotensive mothers without t o c o l y t i c therapy were compared t o determine the e f f e c t s o f severe hypertension and i t s therapy on the preterm neonate. Eight hypertensive mothers (HM) were eclampt i c ; a l l HM received magnesium sulfate; 32% sedatives; and 79% antihypertensive medications. Thrombocytopenia and marked LDH elevation occurred i n 50% o f hypertensive mothers. 39% o f IHM and 0% CI were small f o r gestational age (p < .001); 29% and 0% were microcephalic a t b i r t h ( p < .01). Other s i g n i f i c a n t d i fferences between the two groups o f i n f a n t s were noted i n the i ncidence o f hypotonia, ileus, delayed s t o o l i n g , delayed respirat o r y adaptation, thrombocytopenia, leukopenia, neutropenia, patent ductus arteriosus and b i r t h asphyxia. Maternal thrombocytopenia and enzyme elevations were s i g n i f i c a n t l y associated w i t h growth retardation, microcephaly, thrombocytopenia, neutropenia and b i r t h asphyxia i n the i n f a n t . Gastrointe...

The Effects of Sodium Nitroprusside on Blood Flow and Oxygen Delivery to the Organs of the Hypoxemic Newborn Lamb

“…Sodium nitroprusside is a potent, direct-acting vasodilator which has been used for systemic hypertension (16), pulmonary hypertension (7), and congestive heart failure (6,17). Although experience with nitroprusside in the neonate is limited, two case reports (1,4) have suggested that nitroprusside may have a therapeutic role in decreasing the high pulmonary vascular resistance of hyaline membrane disease.…”