RESUMO
To evaluate the effects of conventional phototherapy and fiberoptic phototherapy on trans-epidermal water loss in preterm infants with and without skin ointment application, 20 infants were randomly assigned to receive conventional or fiberoptic phototherapy for non-hemolytic hyperbilirubinemia. After conventional phototherapy, there were no significant differences in trans-epidermal water loss between ointment-treated and untreated areas. After fiberoptic phototherapy, trans-epidermal water loss significantly increased from ointment-treated and untreated areas, but the increase was less in treated areas.
Assuntos
Tecnologia de Fibra Óptica , Hiperbilirrubinemia/terapia , Recém-Nascido Prematuro , Fototerapia/efeitos adversos , Fototerapia/métodos , Perda Insensível de Água , alfa-Tocoferol/análogos & derivados , Análise de Variância , Humanos , Incubadoras , Recém-Nascido , Pomadas/uso terapêutico , Protetores contra Radiação/uso terapêutico , Temperatura , Fatores de Tempo , Tocoferóis , Vitamina E/análogos & derivados , Vitamina E/uso terapêuticoRESUMO
OBJECTIVE: To evaluate the effect of intravenous ibuprofen and indomethacin for treatment of patent ductus arteriosus (PDA) on mesenteric and renal blood flow velocity in preterm infants. STUDY DESIGN: Seventeen mechanically ventilated preterm infants (<33 weeks' gestation) with PDA received either 0.2 mg/kg indomethacin (n = 8) or 10 mg/kg ibuprofen (n = 9), infused over 15 minutes. Mesenteric and renal blood flow velocity were measured by using Doppler ultrasonography. RESULTS: Indomethacin caused a significant reduction in mesenteric and renal blood flow velocity 30 minutes after drug administration; mesenteric and renal blood flow velocity did not return to the pretreatment values by 120 minutes. Ibuprofen did not alter blood flow 30 minutes after treatment, and blood flow increased 120 minutes after treatment. Mesenteric and renal blood flow velocity changes were significantly different between the 2 treatment groups. CONCLUSIONS: Compared with indomethacin, ibuprofen did not significantly reduce mesenteric and renal blood flow velocity.
Assuntos
Anti-Inflamatórios não Esteroides/uso terapêutico , Permeabilidade do Canal Arterial/fisiopatologia , Ibuprofeno/uso terapêutico , Doenças do Prematuro/fisiopatologia , Recém-Nascido Prematuro , Rim/irrigação sanguínea , Mesentério/irrigação sanguínea , Humanos , Recém-Nascido , Fluxo Sanguíneo Regional/efeitos dos fármacosRESUMO
We used a system capable of measuring conjugated bilirubin and its monoconjugated and diconjugated fractions in serum to assess bilirubin conjugation in 29 glucose-6-phosphate dehydrogenase (G6PD)-deficient, term, male newborn infants and 35 control subjects; all had serum bilirubin levels > or = 256 mumol/L (15 mg/dI). The median value for diconjugated bilirubin was lower in the G6PD-deficient neonates than in control subjects (0.06 (range 0.00 to 1.84) vs 0.21 (range 0.00 to 1.02) mumol/L, p = 0.006). Diglucuronide was undetectable in 11 (38.9%) of the G6PD-deficient infants versus 3 (8.6%) of the control subjects (p = 0.015). These findings imply a partial defect of bilirubin conjugation not previously demonstrated in G6PD-deficient newborn infants.
Assuntos
Bilirrubina/sangue , Deficiência de Glucosefosfato Desidrogenase/sangue , Peso ao Nascer , Estudos de Casos e Controles , Cromatografia Líquida de Alta Pressão , Idade Gestacional , Humanos , Recém-Nascido , MasculinoRESUMO
Sixty-four neonates, with gestational age ranging from 27 1/2 to 40 weeks, postnatal age from 1 to 15 days, and birth weight from 800 to 3400 gm, were given netilmicin 2.5 mg/kg intramuscularly two or three times per day according to postnatal age, for 5 to 14 days. Serum concentrations were measured before and 1 hour after a dose at least twice during treatment. The serum washout profile of the drug was observed in 22 neonates after discontinuation of therapy. Renal function was studied in 37 infants by measuring serum creatinine concentrations and in 27 by urinary excretion of N-acetyl-glucosaminidase during and up to 15 days after therapy. Behavioral and impedance audiometry, and in infants failing those, auditory brainstem evoked response tests, were performed between 6 and 12 months of age. In 23.5% of the neonates, trough serum levels were greater than 3 micrograms/ml. The serum washout followed a multiexponential decay, accounting for distributional, rapid (initial), and slow (tissue) elimination phases. Linear regression analysis performed between each kinetic parameter and gestational age or birth weight showed that initial elimination half-life, steady-state volume of distribution, and total body clearance were significantly correlated with both variables. Netilmicin did not cause detectable renal or auditory damage.
Assuntos
Gentamicinas/metabolismo , Recém-Nascido Prematuro , Rim/fisiologia , Netilmicina/metabolismo , Acetilglucosaminidase/urina , Testes de Impedância Acústica , Audiometria , Creatinina/sangue , Orelha/efeitos dos fármacos , Meia-Vida , Humanos , Recém-Nascido , Rim/efeitos dos fármacos , Cinética , Netilmicina/sangue , Distribuição TecidualRESUMO
The effect of carnitine administration on lipid metabolism and carnitine and acylcarnitine plasma values of newborn infants, given total parenteral nutrition for the first 7 days of life, was studied during a 4-hour infusion of Intralipid. An increase in plasma concentrations of total carnitine, free carnitine, and short-chain and long-chain acylcarnitine was found, but no significant change in triglycerides, free fatty acids, glycerol, or beta-hydroxybutyrate plasma values was noted, as compared with values obtained without carnitine administration. Moreover, the low free carnitine and short-chain and long-chain acylcarnitine plasma levels found in newborn infants after 7 days of total parenteral nutrition did not seem to impair the utilization of infused lipids. The results support the concept that the relation between the carnitine pool and lipid metabolism can be influenced by intravenous glucose infusion. Low carnitine plasma concentrations do not necessarily signify a depletion of body carnitine, and sufficient tissue carnitine concentrations can probably maintain good lipid utilization for an extended period.