ABSTRACT
OBJECTIVE: This study evaluated peripheral vasoconstriction in extremely low birth weight (ELBW) infants when body temperature decreased during the first 12 h of life. STUDY DESIGN: An exploratory, within-subjects design with 10 ELBW infants. Abdominal and foot temperatures were measured every minute. Peripheral vasoconstriction (abdominal>peripheral temperature by 2 degrees C) and abdominal-peripheral temperature difference were also evaluated. RESULTS: Abdominal and peripheral temperatures were significantly correlated within each infant. One 880 g infant exhibited isolated peripheral vasoconstriction; a 960-g infant had abdominal temperatures >1 degrees C higher than peripheral temperatures. Eight smaller infants exhibited no peripheral vasoconstriction and spent most of their observations with peripheral greater than abdominal temperatures. In eight infants, mean temperature difference was significantly higher when abdominal temperature was <36.5 degrees C. CONCLUSION: Most ELBW infants did not exhibit peripheral vasoconstriction during their first 12 h of life, despite low temperatures. ELBW infants' vasomotor control may be immature during this period.
Subject(s)
Body Temperature Regulation/physiology , Infant, Extremely Low Birth Weight/physiology , Infant, Premature/physiology , Vasoconstriction/physiology , Female , Humans , Hypothermia/physiopathology , Infant, Newborn , MaleABSTRACT
OBJECTIVE: The purpose of this study was to determine the effects of prone and supine positioning on the cardiorespiratory stability of preterm infants with apnea and bradycardia. METHODS: A total of 22 preterm infants with symptomatic apnea and bradycardia (gestational age of 26.9 +/- 1.8 weeks and birth weight of 865 +/- 235 gm) were monitored for 24 hours (in four sequential 6-hour blocks) for apnea, bradycardia, and oxygen desaturation in alternating positions (prone or supine) following randomization. Postconceptional age at the time of study was 31.9 +/- 3.0 weeks. Respiratory rate, heart rate, and transcutaneous oxygen saturation were continuously monitored. All episodes of apnea (> or = 10 seconds), bradycardia (< 100 beats per minute), and oxygen desaturation (< 90%) were recorded on an event monitor. Episodes of apnea, bradycardia, and oxygen desaturation were defined as clinically significant if the following criteria were met: apnea, > or = 15 seconds; bradycardia, < 90 beats per minute; and oxygen desaturation, < 80%. All other recorded episodes were considered mild. The episodes were analyzed for statistical significance using the paired t-test. RESULTS: No significant differences (p > 0.05) in the incidence of clinically significant apnea, bradycardia, or desaturation between supine and prone positions were seen in these preterm infants. CONCLUSION: Our results suggest that the cardiorespiratory stability of preterm infants is not significantly compromised by supine positioning.
Subject(s)
Apnea/etiology , Bradycardia/etiology , Infant, Premature , Oxygen Consumption/physiology , Supine Position , Apnea/epidemiology , Bradycardia/epidemiology , Cross-Over Studies , Female , Humans , Incidence , Infant, Newborn , Male , Probability , Prone Position , Sensitivity and Specificity , Sudden Infant Death/prevention & controlSubject(s)
Infant, Premature, Diseases/therapy , Intensive Care, Neonatal/methods , Meconium Aspiration Syndrome/therapy , Program Development , Resuscitation/methods , Adaptation, Physiological , Algorithms , Combined Modality Therapy , Drug Therapy, Combination , Emergencies , Fetal Diseases/diagnosis , Fetal Diseases/physiopathology , Humans , Infant , Infant, Newborn , Intubation, Intratracheal , Oxygen/therapeutic use , Positive-Pressure Respiration , Prenatal Diagnosis , Resuscitation/instrumentationABSTRACT
Amniotic fluid and oropharyngeal aspirate lung maturity profiles obtained simultaneously at delivery in 16 patients are compared. The lecithin/sphingomyelin ratio was greater in oropharyngeal aspirates than in amniotic fluid (p less than 0.02). The percent phosphatidylinositol was greater in oropharyngeal aspirates than in amniotic fluid (p less than 0.03). The mean differences between percent phosphatidylglycerol were not significant. These findings were uninfluenced by the time interval between amniotic fluid and oropharyngeal sampling, gestational age, or neonatal weight. These data could explain the lack of sensitivity of the amniotic fluid lung maturity profile.
Subject(s)
Amniotic Fluid/metabolism , Lung/embryology , Oropharynx , Pulmonary Surfactants/metabolism , Female , Fetal Organ Maturity , Humans , Infant, Newborn , Lung/metabolism , Phosphatidylcholines/metabolism , Phosphatidylglycerols/metabolism , Phosphatidylinositols/metabolism , Pregnancy , Sphingomyelins/metabolism , SuctionABSTRACT
A comprehensive plan for perinatal regionalization in the medical facilities of the military services is advocated. Factors peculiar to military medicine which must be recognized in planning are discussed.