METABOLIC ASPECTS OF IDIOPATHIC RESPIRATORY DISTRESS (HYALINE MEMBRANE SYNDROME) IN NEWBORN INFANTS

[摘要] Measurements of the concentration of nitrogen, potassium and sodium in the blood, and the excretion of these substances in the urine, were made in several groups of newborn infants with and without respiratory distress, presumably caused by the hyaline membrane syndrome. Measurements of hematocrit value, protein in serum, and creatinine in urine were simultaneously obtained from most of the infants.Mean values for excretion of sodium, potassium and nitrogen in the premature infants and infants of diabetic mothers were all increased, as compared with those of term infants of mothers without diabetes. These tendencies were especially marked in those premature infants or diabetic mothers' infants who had respiratory distress.Mean values for nonprotein nitrogen and potassium in plasma were relatively elevated in the blood of premature infants and infants of diabetic mothers and still further elevated if such infants had respiratory distress, but they were highest in a small group of especially premature infants (29 to 32 weeks) who had no distress.Excretion of nitrogen in urine tended to increase in the second 24 hours after birth, whereas concentrations of nitrogen in blood and potassium in plasma were decreasing at that time.It is believed that a pattern of metabolism which includes excessive tissue destruction, shift of water from cells to extracellular space, hyparkalemia, and excessive excretion of sodium, occurs during the first 48 hours postnatally in infants with respiratory distress. However, the same phenomena may occur to a lesser extent in premature infants or infants of diabetic mothers, without distress, and may occur to an even greater degree in extreme prematurity alone. Probably the shifts of body water occasioned by this metabolic disturbance are not the cause of the distress, and they may occur without distress.Interesting similarities occur between the chemical events in these infants and those in newborn animals subjected to stress (as by exposure to cold) or human adults during and after anesthesia and surgery.Oral or intravenous glucose administration in the second 12 hours after birth did not prevent hyperkalemia in infants who received this early caloric intake, though some reduction of body tissue consumption may have occurred when glucose was thus given.

[学科分类] 儿科学