INTRAVENTRICULAR HEMORRHAGE (IVH) &amp; VITAMIN E (VE) IN VERY LOW BIRTH WEIGHT INFANTS: EFFICACY OF EARLY IM ADMINISTRATION

Speer, Michael E.; Blifeld, Cindy; Rudoph, Arnold J; Chadda, Prabhujeet; Holbein, Blair; Hittner, Helen Mintz

doi:10.1203/00006450-198404001-01739

Cited by 15 publications

(23 citation statements)

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“…Vitamin E, or or-tocopherol, is administered to many low birth weight infants in an attempt to decrease the incidence of severe retinopathy of prematurity (1-3) intraventricular hemorrhage (4)(5)(6), and possibly mortality (5)(6)(7). Recently, pharmacologic levels of vitamin E (5 mg/dl) have been associated with an increased risk for sepsis and necrotizing enterocolitis (8).…”

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confidence: 99%

Vitamin E Decreases Superoxide Anion Production by Polymorphonuclear Leukocytes

et al. 1988

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ABSTRACT. Pharmacologic serum levels of vitamin E total oxygen radical generation). To further investigate the deadministered to low birth weight infants predispose them pressant effect of pharmacologic levels of vitamin E on PMN to infectious complications. We studied in vitro the effect oxidative metabolism we have studied superoxide anion producof vitamin E, its vehicle and buffer (Krebs Ringers phos-tion in vitro by PMN exposed to pharmacologic levels of vitamin phate glucose) on the ability of human polymorphonuclear E. leukocytes (PMN) to produce superoxide anion, an oxygen radical important for bacterial killing. We found that superoxide anion production after a 5-min exposure to phor- Vitamin E, or or-tocopherol, is administered to many low birth weight infants in an attempt to decrease the incidence of severe retinopathy of prematurity (1-3) intraventricular hemorrhage (4-6), and possibly mortality (5-7). Recently, pharmacologic levels of vitamin E (5 mg/dl) have been associated with an increased risk for sepsis and necrotizing enterocolitis (8). We and others have hypothesized that this increased risk for infectious complications may be related to altered host defenses, specifically polymorphonuclear leukocyte oxygen radical production (8).In vitro, pharmacologic levels of vitamin E have been associated with decreased PMN chemotaxis, random migration, and bactericidal activity (9-1 1). Decreased oxygen radical production by PMN has also been found in the presence of high vitamin E levels. Baehner et al.(1 1). demonstrated decreased hydrogen peroxide production but normal superoxide anion production. Shigeoka et al. (12) found that PMN from stressed neonates and treated with high concentrations of vitamin E responded to stimuli with significantly less chemiluminescence (a measure of Chemicals. Vitamin E (AT) and its V were graciously supplied by Hoffmann-LaRoche, Inc., Nutley, NJ. The composition of the preparation is identical to that given to neonates in whom an increased risk for sepsis and necrotizing enterocolitis was identified (Table 1). The free tocopherol was used in our experiments because it is the form of vitamin E found in the serum and tissues after administration of various formulations of vitamin E (i.e tocopherol acetate, tocopherol succinate). KRPG (pH 7.4) was the buffer utilized for cell preparation and during the superoxide anion assay. Potassium phosphate buffer (pH 7.5) was used during the LDH assay. Superoxide dismutase cytochrome C, PMA, NEM, pyruvic acid, nicotinamide adenine dinucleotide, calcium chloride, sodium chloride, magnesium chloride, disodium mon~phosphate, and potassium chloride were obtained from Sigma Chemical Company, St. Louis, MO. Sodium azide was obtained from Fisher Scientific, Cincinnati, OH.Collection and separation of PMN. Venous blood was obtained from healthy adult donors according to the institution's informed consent Heparin (10 U/ml) was used as the anticoagulant. PMN were isolated by Ficoll-Hypaque density centrifugation according to the method of Boy...

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confidence: 99%

Vitamin E Decreases Superoxide Anion Production by Polymorphonuclear Leukocytes

et al. 1988

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“…The incidence of intracranial hemorrhage in premature infants receiving supplemental intravenous or oral a-tocopheryl acetate has been reported as increased (Phelps et al, 1987), unchanged (Speer et al, 1984), or decreased (Speer et al, 1984) depending on the severity of the hemorrhage. It may well be that the small premature infant is particularly vulnerable to the toxic effects of vitamin E and that intravenous vitamin E is more toxic than the oral preparation.…”

Section: Adverse Effects In Prematurementioning

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Establishment of Dietary Reference Intakes for Dietary Antioxidants

Meyers¹

2000

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“…In this patient group an adequate supply of vitamins A and E is of great relevance, since they have low body stores at birth (Brandt et al, 1978;Dju et al, 1952), high needs for growth and development and a poor antioxidant defense system. Administration of vitamins A and E to very premature infants has been associated with lower incidence and less severity of bronchopulmonary dysplasia, retinopathy of prematurity and intracranial hemorrhage (Johnson et al, 1989(Johnson et al, , 1995Papagaroufalis et al, 1991;Shenai et al, 1987;Speer et al, 1984).…”

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confidence: 99%

Losses of vitamin A and E in parenteral nutrition suitable for premature infants

2002

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Objective: To assess the bioavailability of vitamins A and E administered parenterally with either water-soluble or lipid-soluble preparations. Study design: A water soluble preparation (MVI Pediatric 1 ) administered with a glucose -amino acid solution and a lipid soluble preparation (Vitalipid N Infant 1 ) infused with a lipid emulsion were subjected to phototherapy light, different flow rates, light protection, different tubing materials and tubing sizes, and concentrations in the effluents were determined. Results: Recovery of retinol in glucose-amino acid solution was poor under all conditions (16 -30% without; 21 -42% with light protection tubing) and increased to 61% with polyethylene and to 44% with polyurethane tubings. Polyurethane tubings with reduced volume improved retinol delivery to 56%. Retinylpalmitate (Vitalipid) losses were low, with recovery of 86 and 77% with and without light protection, respectively. Recoveries of a-tocopherylacetate in GLUC-AA were 103 -107% without and 94 -102% with light protection and of a-tocopherol in LIPID 89% without and 85% with light protection. Conclusions: Parenteral vitamin A delivery is improved by the infusion of retinylpalmitate with lipids. Light protecting tubings provide only a marginal benefit with artificial light and none with phototherapy light. Polyethylene and polyvinylchloride tubings adsorb less retinol than polyurethane tubings. Small tubing diameters resulting in higher flow rates enhance retinol delivery.

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INTRAVENTRICULAR HEMORRHAGE (IVH) & VITAMIN E (VE) IN VERY LOW BIRTH WEIGHT INFANTS: EFFICACY OF EARLY IM ADMINISTRATION

Cited by 15 publications

References 0 publications

Vitamin E Decreases Superoxide Anion Production by Polymorphonuclear Leukocytes

Vitamin E Decreases Superoxide Anion Production by Polymorphonuclear Leukocytes

Establishment of Dietary Reference Intakes for Dietary Antioxidants

Losses of vitamin A and E in parenteral nutrition suitable for premature infants

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