静脉注射脂质对新生儿游离脂肪酸浓度和白蛋白与胆红素结合能力的影响。

Czechoslovak medicine Pub Date : 1989-01-01
P Zoban, H Tomásová, V Mydlil, J Karas, E Michková
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引用次数: 0

摘要

在24小时间隔内,对5例足月新生儿和4例早产儿进行了检查,未发现产后适应障碍。新生儿平均在7小时内接受含20%脂质输液剂的肠外营养。Intralipid的平均日剂量为1.2 g/kg,输注速率为0.17 g/kg/h。测定FFA (n = 9)和ABC/Bi浓度,分别在24小时内、脂质注射前、输注1小时后和输注结束后约17小时内检测3次。在输注前和第一次采集后24 h检测血胆红素、葡萄糖浓度,pH、pCO2、BE值(= 9)。脂质内注射开始1小时后,平均FFA浓度下降,在随后的23小时内再次下降。这些差异基本上是微不足道的。开始给药1小时后,ABC/Bi比值平均值下降不明显,但随访结束(24小时)时恢复到初始值。胆红素和血糖的平均浓度以及pH、pCO2和BE值无明显变化。可以合理地假设,对于出生后适应正常的新生儿,给予20%脂质内(作为肠外营养)对24小时血浆FFA浓度和ABC/Bi比值没有实质性影响。给出了新生儿肠外脂质内给药指征的一般原则。
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Influence of intravenously administered intralipid on free fatty acid concentration and albumin binding capacity to bilirubin in newborn infants.

During a 24-hour interval, examination was carried out of 5 full-term and 4 preterm newborns in whom no disturbance of postnatal adaptation was found. The newborns received parenteral nutrition using infusates containing 20% Intralipid during 7 hours on the average. The mean daily dose of Intralipid was 1.2 g/kg, infusion rate was 0.17 g/kg/h. The concentration of FFA (n = 9) and ABC/Bi was examined three times in the course of 24 hours, and that prior to Intralipid administration, after one-hour infusion, and approximately 17 hours after the end of infusion. Before infusion and 24 hours after the first collection, blood bilirubin and glucose concentrations, and the values of pH, pCO2 and BE (= 9) were examined. One hour after the start of Intralipid infusion the mean FFA concentration was reduced and decreased again during the following 23 hours. The differences were mostly insignificant. One hour after the start of infusion the mean value of the ABC/Bi ratio decreased insignificantly, but returned to the initial value by the end of the follow-up period (24 hours). The mean concentration of bilirubin and blood glucose and the values of pH, pCO2 and BE did not change significantly. It may be reasonably assumed, that in newborns showing normal postnatal adaptation in the first days of life, the administration of 20% Intralipid (as parenteral nutrition) exerts no substantial effect on the plasma FFA concentration and ABC/Bi ratio in the course of 24 hours. General principles for the indication of parenteral Intralipid administration to the newborn are given.

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