Asunto(s)
Alcoholes Bencílicos/envenenamiento , Diazepam/administración & dosificación , Benzoatos/sangre , Ácido Benzoico , Alcohol Bencilo , Alcoholes Bencílicos/sangre , Preescolar , Diazepam/uso terapéutico , Femenino , Humanos , Infusiones Intravenosas , Estado Epiléptico/tratamiento farmacológicoRESUMEN
Intraventricular hemorrhage and death in preterm neonates has been associated with the use of fluid containing benzyl alcohol, a bacteriostatic agent, to flush intravascular catheters. The hospital and autopsy records of infants admitted to a nursery during the last 18 months that benzyl alcohol was in use (218 patients) were reviewed and compared with those of infants admitted in the first 18 months after benzyl alcohol was withdrawn (232 patients). The volume of flush solution administered to each patient was estimated. Exposure to benzyl alcohol was significantly associated with the development of kernicterus (P less than .005), and intraventricular hemorrhage (P less than .000,000,5). Kernicterus did not develop in any patient after benzyl alcohol was withdrawn. Many patients with kernicterus or intraventricular hemorrhages received small daily volumes of fluid containing benzyl alcohol. Withdrawal of benzyl alcohol from clinical use had no demonstrable effect on mortality. Medications intended for neonatal use should not contain benzyl alcohol. Our data indicate that patients not exposed to benzyl alcohol have a greatly reduced risk of kernicterus. If this finding is confirmed by other investigators, present indications for exchange transfusions in preterm infants with moderate elevations of serum bilirubin should be reconsidered.
Asunto(s)
Alcoholes Bencílicos/efectos adversos , Compuestos de Bencilo/efectos adversos , Hemorragia Cerebral/inducido químicamente , Ventrículos Cerebrales , Mortalidad Infantil , Recien Nacido Prematuro , Kernicterus/inducido químicamente , Alcohol Bencilo , Alcoholes Bencílicos/administración & dosificación , Alcoholes Bencílicos/envenenamiento , Hemorragia Cerebral/epidemiología , Ventrículos Cerebrales/efectos de los fármacos , Estudios de Cohortes , Femenino , Humanos , Recién Nacido , Infusiones Intravenosas , Kernicterus/epidemiología , Masculino , Factores de TiempoAsunto(s)
Alcoholes Bencílicos/toxicidad , Compuestos de Bencilo/toxicidad , Animales , Alcohol Bencilo , Alcoholes Bencílicos/envenenamiento , Relación Dosis-Respuesta a Droga , Exposición a Riesgos Ambientales , Femenino , Cobayas , Dosificación Letal Mediana , Masculino , Concentración Máxima Admisible , Ratones , Conejos , Ratas , Caracteres Sexuales , Especificidad de la EspecieAsunto(s)
Alcoholes Bencílicos/envenenamiento , Compuestos de Bencilo/envenenamiento , Enfermedades del Prematuro/inducido químicamente , Adulto , Alcohol Bencilo , Alcoholes Bencílicos/sangre , Cateterismo , Edema/terapia , Femenino , Humanos , Recién Nacido , Enfermedades del Prematuro/sangre , Embarazo , Cloruro de Sodio , Arterias UmbilicalesRESUMEN
Epidemiologic studies have provided much of the knowledge concerning adverse side effects of exposure to drugs and other xenobiotics transmitted via breast milk. Adverse effects can be immediate and usually recognizable or long-term and difficult to define. Acute effects may be due to individual idiosyncrasy, allergic reaction, or manifestation of acute toxicity. We need further human clinical investigations to determine actual dosing to nursing infants and to ascertain the existence of subtle and presently unrecognized long-term effects.
Asunto(s)
Contaminación de Alimentos , Trastornos de la Nutrición del Lactante/etiología , Leche Humana , Leche , Animales , Avitaminosis/etiología , Alcoholes Bencílicos/envenenamiento , Botulismo/etiología , Lactancia Materna , Bovinos , Contaminantes Ambientales/toxicidad , Femenino , Heparina/envenenamiento , Humanos , Hipernatremia/etiología , Recién Nacido , Cinética , Minerales/deficiencia , Preparaciones Farmacéuticas/metabolismo , Embarazo , Desnutrición Proteico-Calórica/etiologíaAsunto(s)
Alcoholes Bencílicos/envenenamiento , Compuestos de Bencilo/envenenamiento , Enfermedades del Prematuro/inducido químicamente , Acidosis/inducido químicamente , Alcohol Bencilo , Alcoholes Bencílicos/orina , Enfermedades del Sistema Nervioso Central/inducido químicamente , Humanos , Recién Nacido , Unidades de Cuidado Intensivo Neonatal , Insuficiencia Respiratoria/inducido químicamenteAsunto(s)
Antiinfecciosos/envenenamiento , Alcoholes Bencílicos/envenenamiento , Compuestos de Bencilo/envenenamiento , Enfermedades del Prematuro/inducido químicamente , Alcohol Bencilo , Alcoholes Bencílicos/administración & dosificación , Alcoholes Bencílicos/metabolismo , Humanos , Recién Nacido , Inyecciones Intravenosas , Unidades de Cuidado Intensivo Neonatal , Respiración , SíndromeRESUMEN
Severe flaccid paraplegia accompanied by extensive sensory loss after epidural anesthesia administered for labor and delivery occurred in a previously healthy 24-year-old primagravida. Recovery was virtually complete after 16 months. The cause of the neurologic deficits may have been the 1.5 percent benzyl alcohol preservative contained in an 0.9 percent saline solution used for postdelivery epidural injection.
