Regulation of extracellular fluid volume in neonates

Simpson, John; Stephenson, Terence

doi:10.1016/0378-3782(93)90175-t

Cited by 23 publications

(7 citation statements)

References 78 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In the present study, we compared the changes of the amount of peritoneal fluid between the groups as a parameter of capillary leakage because neonates and infants have a particular propensity for capillary leakage into the peritoneal cavity. 21 Although insignificant, there was a trend toward reduced peritoneal fluid discharge in the first 24 h in the MUF-treated group. Given the fact that the major factors causing capillary leakage are hemodilution, fluid overload and inflammatory response, 14,20 it can be hypothesized that MUF could, not perfectly but partly, address these major factors, thereby potentially attenuating capillary leak after neonatal open-heart surgery.…”

Section: Discussionmentioning

confidence: 99%

Effect of Modified Ultrafiltration on Postoperative Course in Neonates With Complete Transposition of the Great Arteries Undergoing Arterial Switch Operation

Kotani

Honjo

Osaki

et al. 2008

Circ J

View full text Add to dashboard Cite

verall outcomes of neonatal open-heart surgery have been dramatically improved over the past 2 decades owing to refinements of preoperative, intraoperative and postoperative management. The current early mortality rate of patients with transposition of the great arteries (TGA) with intact atrial septum (TGA-IAS) and TGA with ventricular septal defect (TGA-VSD) undergoing arterial switch operation (ASO) is approximately 2-7%, 1,2 a considerable improvement from the mortality rate of about 15% in earlier eras. 3 Interest has therefore been shifted from reducing operative mortality to facilitating quicker recovery and reducing intensive care unit (ICU) stay and hospital stay by applying an early extubation policy and/or fast-track cardiac surgery pathways. [4][5][6] However, stress response to cardiopulmonary bypass (CPB) is much greater in neonates than in older children, 7 and postoperative recovery in neonates can therefore often be compromised by CPB-induced organ dysfunction.Modified ultrafiltration (MUF), which was introduced by Naik et al in 1991, has become an essential perfusion strategy to minimize CPB-induced adverse effects in pediatric patients undergoing open-heart surgery. 8 A substantial body of evidence showed that MUF improves cardiac, pulmonary and cerebral functions 9-12 and decreases postoperative bleeding and blood transfusion requirement 13 by reduction of body water accumulation, reversal of hemodilution, and modulation of systemic inflammatory mediators. 9,14 The beneficial effects of MUF are thought to be greatest in neonates who have the largest body weight/CPB circuit volume mismatch and are therefore most vulnerable to exposure to hypothermia and crystalloid hemodilution; however, the effect of MUF on clinical outcomes in neonates undergoing open-heart surgery has not been clarified in previous studies. 13,15,16 We hypothesized that MUF accelerates the recovery in neonates undergoing open-heart surgery by early recovery of hemodynamics and pulmonary function and by attenuation of capillary leakage, thereby contributing to our 'fast-track' strategy. To test our hypothesis, we analyzed patients with TGA-IAS and TGA-VSD who underwent ASO with or without MUF because of relative homogeneity of the patients' characteristics, standardized surgical procedure, low operative mortality, and favorable early and long-term hemodynamic results, 17,18 providing a better picture of impacts of MUF on early clinical outcomes in neonatal patients. MethodsWe conducted a retrospective study of neonates who underwent ASO from April 1998 to September 2006 at Okayama University Hospital. The Institutional Review

show abstract

Section: Discussionmentioning

confidence: 99%

Effect of Modified Ultrafiltration on Postoperative Course in Neonates With Complete Transposition of the Great Arteries Undergoing Arterial Switch Operation

Kotani

Honjo

Osaki

et al. 2008

Circ J

View full text Add to dashboard Cite

show abstract

“…M6G [9,29]. Most studies examining glomerular filtration rate in infants with respiratory distress synOur data therefore suggest that the metabolism of morphine in neonates, in terms of the respective drome have shown that this is reduced [30 ]. Two studies have reported values for the elimination clearance contributions of each pathway, is not markedly dissimilar from that in adults who have received intraof M6G, giving values of approximately 1.50-2.75 ml min−1 kg−1 [8,9].…”

Section: Discussionmentioning

confidence: 99%

“…However, as can be seen above, the role of 3 7 41 2. 30 active metabolites in the pharmacology of morphine 4 15 28 1.10 necessitates a more comprehensive study of the dispo-5 19 28 1.33 sition of opiates and their metabolites [20 ]. This is 6 9 29 1.…”

Section: Introductionmentioning

confidence: 99%

Morphine, morphine‐6‐glucuronide and morphine‐3‐glucuronide pharmacokinetics in newborn infants receiving diamorphine infusions

Barrett

Barker

Rutter

et al. 1996

Brit J Clinical Pharma

View full text Add to dashboard Cite

1 The pharmacokinetics of morphine, morphine-6-glucuronide (M6G) and morphine-3-glucuronide (M3G) were studied in 19 ventilated newborn infants ( 24-41 weeks gestation) who were given a loading dose of 50 mg kg−1 or 200 mg kg−1 of diamorphine followed by an intravenous infusion of 15 mg kg−1 h−1 of diamorphine. Plasma concentrations of morphine, M3G and M6G were measured during the accrual to steady-state and at steady state of the diamorphine infusion. 2 Following both the 50 mg kg−1 or 200 mg kg−1 loading doses the mean steadystate plasma concentration (±s.d.) of morphine, M3G and M6G were 86±52 ng ml−1, 703±400 ng ml−1 and 48±28 ng ml−1 respectively and morphine clearance was found to be 4.6±3.2 ml min−1 kg−1. 3 M3G formation clearance was estimated to be 2.5±1.8 ml min−1 kg−1, and the formation clearance of M6G was estimated to be 0.46±0.32 ml min−1 kg−1. 4 M3G metabolite clearance was 0.46±0.60 ml min−1 kg−1, the elimination half-life was 11.1±11.3 h and the volume of distribution was 0.55±1.13 l kg−1. M6G metabolite clearance was 0.71±0.36 ml min−1 kg−1, the elimination half-life was 18.2±13.6 h and the volume of distribution was 1.03±0.88 l kg−1. 5 No significant effect of the loading dose (50 mg kg−1 or 200 mg kg−1) on the plasma morphine or metabolite concentrations or their derived pharmacokinetic parameters was found. 6 We were unable to identify correlations between gestational age of the infants and any of the determined pharmacokinetic parameters. 7 M3G5morphine and M6G5morphine steady-state plasma concentration ratios were 11.0±10.8 and 0.8±0.8, respectively. 8 The metabolism of morphine in neonates, in terms of the respective contributions of each glucuronide pathway, was similar to that in adults.

show abstract

“…However, the animals in this study were fed to satiation three to five times a day, making dehydration an unlikely cause. Some studies have suggested that water movement within pinnipeds is complicated and not well understood, so the observed decrease in Hct and Hb could be affected by the complex shifting of body fluids [47–49]. …”

Section: Discussionmentioning

confidence: 99%

Diving Related Changes in the Blood Oxygen Stores of Rehabilitating Harbor Seal Pups (Phoca vitulina)

Amber

Ono

2015

PLoS ONE

View full text Add to dashboard Cite

Harbor seal (Phoca vitulina) pups begin diving within hours of birth, stimulating the development of the blood oxygen (O2) stores necessary to sustain underwater aerobic metabolism. Since harbor seals experience a brief nursing period, the early-life development of these blood O2 stores is necessary for successful post-weaning foraging. If mothers and pups become prematurely separated, the pup may be transported to a wildlife rehabilitation center for care. Previous studies suggest that the shallow pools and lack of diving in rehabilitation facilities may lead to under-developed blood O2 stores, but diving behavior during rehabilitation has not been investigated. This study aimed to simultaneously study the diving behaviors and blood O2 store development of rehabilitating harbor seal pups. Standard hematology measurements (Hct, Hb, RBC, MCV, MCH, MCHC) were taken to investigate O2 storage capacity and pups were equipped with time-depth recorders to investigate natural diving behavior while in rehabilitation. Linear mixed models of the data indicate that all measured blood parameters changed with age; however, when compared to literature values for wild harbor seal pups, rehabilitating pups have smaller red blood cells (RBCs) that can store less hemoglobin (Hb) and subsequently, less O2, potentially limiting their diving capabilities. Wild pups completed longer dives at younger ages (maximum reported <25 days of age: 9 min) in previous studies than the captive pups in this study (maximum <25 days of age: 2.86 min). However, captivity may only affect the rate of development, as long duration dives were observed (maximum during rehabilitation: 13.6 min at 89 days of age). Further, this study suggests that there may be a positive relationship between RBC size and the frequency of long duration dives. Thus, rehabilitating harbor seal pups should be encouraged to make frequent, long duration dives to prepare themselves for post-release foraging.

show abstract

Regulation of extracellular fluid volume in neonates

Cited by 23 publications

References 78 publications

Effect of Modified Ultrafiltration on Postoperative Course in Neonates With Complete Transposition of the Great Arteries Undergoing Arterial Switch Operation

Effect of Modified Ultrafiltration on Postoperative Course in Neonates With Complete Transposition of the Great Arteries Undergoing Arterial Switch Operation

Morphine, morphine‐6‐glucuronide and morphine‐3‐glucuronide pharmacokinetics in newborn infants receiving diamorphine infusions

Diving Related Changes in the Blood Oxygen Stores of Rehabilitating Harbor Seal Pups (Phoca vitulina)

Contact Info

Product

Resources

About