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Parenteral alimentation of premature infants under 1,200 grams
838
Ultrapore
ABSTRACTS
Hemofiltration:
The
Effects
on
the
Coagulation and Fibrinolytic Mechanisms in Fresh and Stored Blood. A. S. Cervin. T. J. Limbird, C. L. Puckett. and D. Silver. Arch. Surg. 106:333-336 (March), 1973. Posttransfusion microembolism is receiving more attention these days and articles on ultrapore hemofiltration are appearing in the surgical literature with some regularity. From Duke University comes this elegant study of the effect of such filtration on bank and freshly drawn blood. It is concluded that the use of Dacron wool filters is contraindicated during the transfusion of fresh blood or platelet packs employed as primary therapy for tlirombocytopenia or platelet dysfunction. The grid filter does not remove platelets and could, therefore, be used in this situation. In other blood transfusions, however, and especially in pulmonary sjtuations involving progressive compromise, the Dacron wool filter should be used. It is demonstrated that during massive transfusions of stored blood, the Dacron wool filter effectively removes microaggregates, potentially harmful debris, and nonfunctional platelets.--Edward J. Berman Parenteral Under
Alimentation 1,200
Grams.
of Premature Eugene
A.
Infants Dolanski,
Mildred T. Stahlman, and H. C. Meng. South. Med. J. 66:41-46
(January),
1973.
It has been shown that in infants qualitative and quantitative changes occur both in muscle and brain tissue if caloric, especially proteincaloric, deprivation occurs during the most rapid periods of cell proliferation. This period occurs in the human infant during the last months of intrauterine life and during the early postnatal period. The prematurely born infant thus is removed from his source of nutrition at the most critical period of his growth. The small neonate can tolerate only limited quantities of food orally, even when concentrated formulae and gavage feedings are used. Following the work of Dudrick and Wilmore, the authors have used hypertonic solutions as intravenous supplements or total nutrients in three premature infants under 1200 g of weight. Because of limitation in size of vessels, it was decided to use umbilical veins for delivery of fluids. The tip of the catheter was positioned above the diaphragm. A 207; solution of TPAI-900 which supplied 900 cal per liter was used. During the period of hyperalimentation, the
three infants experienced no adverse effects. Only mild transient acidosis occurred and this was easily overcome by changing the concentration of the infusate. Parenteral alimentation was effective in quickly achieving positive nitrogen balance while receiving an average of 0.40.5 g/kg/day of Nz and a total caloric intake of 100-l I8 Cal/kg/day.-George Holcomb
ANESTHESIA
AND INHALATION THERAPY
Pancuronium Bromide: A Double-Blind Study in Children. E. J. Bennett, D. E. Bowyer, A. H. Giesecke, and C. R. Stephen. Anesth. Analg. (Paris). 52:12-I8 (January-February), 1973. The effects of pancuronium bromide, a nondepolarizing neuromuscular blocking agent, were compared with those of d-tubocurarine (dTC) in a double-blind study involving 100 pediatric patients undergoing short elective procedures. Nitrous oxide was used as the sole maintenance anesthetic agent. With pancuronium bromide (94 mg/kg.) onset of action was noted to be slightly prolonged and duration of action significantly shorter than with dTC (450 rg/kg). Conditions for intubation were considered less than optimal in the pancuronium group and in S/l00 cases there was incomplete reversal with a standardized dose of atropine (0.018 mg/kg) and neostigmine (0.08 mg/kg). The relaxant effect of the two drugs was uniformly good. The most significant difference between the two drugs was that blood pancuronium increased pulse rate, pressure, and cardiac output significantly suggesting that it might be a better relaxing agent to use in poor-risk patients when compromise of the cardiovascular system is to be avoided.Barbara H. Towne Postoperative Respiratory Insufficiency in Children Treated by use of Respirator. B. Hu?in and J. Stark. Cesk. Pediatr. 26: 424-427 (September), I97 I. The common cause of postoperative respirator) insufficiency after thoracocardiao surgery in children is hypoventilation. The most frequent causes of respiratory difficulties in infants and children are: the obstruction of the upper respiratory tract by mucus, protracted influence of narcotics and of myorelaxant drugs, pathologic changes of lungs due to the left-right
Ultrapore
ABSTRACTS
Hemofiltration:
The
Effects
on
the
Coagulation and Fibrinolytic Mechanisms in Fresh and Stored Blood. A. S. Cervin. T. J. Limbird, C. L. Puckett. and D. Silver. Arch. Surg. 106:333-336 (March), 1973. Posttransfusion microembolism is receiving more attention these days and articles on ultrapore hemofiltration are appearing in the surgical literature with some regularity. From Duke University comes this elegant study of the effect of such filtration on bank and freshly drawn blood. It is concluded that the use of Dacron wool filters is contraindicated during the transfusion of fresh blood or platelet packs employed as primary therapy for tlirombocytopenia or platelet dysfunction. The grid filter does not remove platelets and could, therefore, be used in this situation. In other blood transfusions, however, and especially in pulmonary sjtuations involving progressive compromise, the Dacron wool filter should be used. It is demonstrated that during massive transfusions of stored blood, the Dacron wool filter effectively removes microaggregates, potentially harmful debris, and nonfunctional platelets.--Edward J. Berman Parenteral Under
Alimentation 1,200
Grams.
of Premature Eugene
A.
Infants Dolanski,
Mildred T. Stahlman, and H. C. Meng. South. Med. J. 66:41-46
(January),
1973.
It has been shown that in infants qualitative and quantitative changes occur both in muscle and brain tissue if caloric, especially proteincaloric, deprivation occurs during the most rapid periods of cell proliferation. This period occurs in the human infant during the last months of intrauterine life and during the early postnatal period. The prematurely born infant thus is removed from his source of nutrition at the most critical period of his growth. The small neonate can tolerate only limited quantities of food orally, even when concentrated formulae and gavage feedings are used. Following the work of Dudrick and Wilmore, the authors have used hypertonic solutions as intravenous supplements or total nutrients in three premature infants under 1200 g of weight. Because of limitation in size of vessels, it was decided to use umbilical veins for delivery of fluids. The tip of the catheter was positioned above the diaphragm. A 207; solution of TPAI-900 which supplied 900 cal per liter was used. During the period of hyperalimentation, the
three infants experienced no adverse effects. Only mild transient acidosis occurred and this was easily overcome by changing the concentration of the infusate. Parenteral alimentation was effective in quickly achieving positive nitrogen balance while receiving an average of 0.40.5 g/kg/day of Nz and a total caloric intake of 100-l I8 Cal/kg/day.-George Holcomb
ANESTHESIA
AND INHALATION THERAPY
Pancuronium Bromide: A Double-Blind Study in Children. E. J. Bennett, D. E. Bowyer, A. H. Giesecke, and C. R. Stephen. Anesth. Analg. (Paris). 52:12-I8 (January-February), 1973. The effects of pancuronium bromide, a nondepolarizing neuromuscular blocking agent, were compared with those of d-tubocurarine (dTC) in a double-blind study involving 100 pediatric patients undergoing short elective procedures. Nitrous oxide was used as the sole maintenance anesthetic agent. With pancuronium bromide (94 mg/kg.) onset of action was noted to be slightly prolonged and duration of action significantly shorter than with dTC (450 rg/kg). Conditions for intubation were considered less than optimal in the pancuronium group and in S/l00 cases there was incomplete reversal with a standardized dose of atropine (0.018 mg/kg) and neostigmine (0.08 mg/kg). The relaxant effect of the two drugs was uniformly good. The most significant difference between the two drugs was that blood pancuronium increased pulse rate, pressure, and cardiac output significantly suggesting that it might be a better relaxing agent to use in poor-risk patients when compromise of the cardiovascular system is to be avoided.Barbara H. Towne Postoperative Respiratory Insufficiency in Children Treated by use of Respirator. B. Hu?in and J. Stark. Cesk. Pediatr. 26: 424-427 (September), I97 I. The common cause of postoperative respirator) insufficiency after thoracocardiao surgery in children is hypoventilation. The most frequent causes of respiratory difficulties in infants and children are: the obstruction of the upper respiratory tract by mucus, protracted influence of narcotics and of myorelaxant drugs, pathologic changes of lungs due to the left-right