Central–peripheral temperature difference, blood pressure, and arginine vasopressin in preterm neonates undergoing volume expansion

• Published in: Archives of disease in childhood. Fetal and neonatal edition Vol. 78; no. 1; pp. F43 - F45
• Main Authors: Lambert, Heather J, Baylis, Peter H, Coulthard, Malcolm G
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health 01-01-1998; BMJ; BMJ Publishing Group LTD; BMJ Group
• Subjects: Adults; albumin; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Arginine Vasopressin - blood; Biological and medical sciences; Blood Pressure; Body Temperature; central peripheral temperature; Emergency and intensive care: neonates and children. Prematurity. Sudden death; Expansion; Humans; hypovolaemia; Infant, Newborn; Infant, Premature; Infant, Premature, Diseases - blood; Infant, Premature, Diseases - physiopathology; Infant, Premature, Diseases - therapy; Infusions, Intravenous; Intensive care; Intensive care medicine; Medical sciences; Neonates; Original; Plasma; plasma arginine vasopressin; Plasma Substitutes - therapeutic use; Serum Albumin - therapeutic use; Shock - blood; Shock - physiopathology; Shock - therapy; Studies; systolic blood pressure; Human; Premature; Hypovolemia; 8-Arginine vasopressin; Body temperature; Peptide hormone; Plasma volume; Volume expansion; Central temperature; Peripheral hemodynamics; Neuropeptide; Peripheral temperature; Newborn; Neurohypophyseal hormone; Arterial pressure; Biological effect
• ISSN: 1359-2998; 1468-2052
• DOI: 10.1136/fn.78.1.F43

AIM To examine the effect of intravascular volume expansion for the treatment of hypovolaemia in sick preterm neonates. METHODS An intravenous infusion of 20 ml per kg of 4.5 % albumin was given to 14 preterm neonates. The effects on systolic blood pressure, central peripheral temperature difference (c-pT), and plasma arginine vasopressin concentration (pAVP) were measured. RESULTS Thirteen babies showed a rise in systolic blood pressure. The six babies with the highest initial values of pAVP and c-pT showed a fall in both of these after infusion. The babies with lower initial pAVP (below 4 pmol/l) showed either a rise (two) or no change (six) after albumin infusion. There was a significant correlation between c-pT and log pAVP before (r2=0.61; p<0.05) and after infusion (r2=0.45; p<0.05). CONCLUSIONS Plasma AVP concentration is related to c-pT in unwell preterm newborns. This study suggests that clinical assessment of hypovolaemia in preterm newborns is poor and could be improved by using c-pT.