Pression oncotique et détresse respiratoire néonatale

Zimmermann, Bernhard; Françoise, M; Germain, JL; Lallemant, Christian; Gouyon, Jean‐Bernard

doi:10.1016/s0929-693x(97)86090-3

Cited by 9 publications

(5 citation statements)

References 31 publications

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“…The present study was not designed to investigate the pathophysiological basis of the association ‘plasma protein and in-hospital outcome’ of VLBWI, but we have previously described a significant positive correlation between low colloid oncotic pressure, low total protein levels and hypotension on day 1 of life in newborns with respiratory distress [25], and we hypothesised in one recent paper that low early protein levels may impair maintenance of intravascular volume and adequate blow flow to vital organs in critically ill premature babies [9].…”

Section: Discussionmentioning

confidence: 98%

Total Plasma Protein in Very Preterm Babies: Prognostic Value and Comparison with Illness Severity Scores

et al. 2013

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ObjectiveWe aimed to investigate the predictive value for severe adverse outcome of plasma protein measurements on day one of life in very preterm infants and to compare total plasma protein levels with the validated illness severity scores CRIB, CRIB-II, SNAP-II and SNAPPE-II, regarding their predictive ability for severe adverse outcome.MethodsWe analyzed a cohort of infants born at 24–31 weeks gestation, admitted to the tertiary intensive care unit of a university hospital over 10.5 years. The outcome measure was “severe adverse outcome” defined as death before discharge or severe neurological injury on cranial ultrasound. The adjusted odd ratio (aOR) and 95% confidence interval (95% CI) of severe adverse outcome for hypoproteinemia (total plasma protein level <40 g/L) was calculated by univariate and multivariate analyses. Calibration (Hosmer-Lemeshow goodness-of-fit) was performed and the predictive ability for severe adverse outcome was assessed for total plasma protein and compared with CRIB, CRIB-II, SNAP-II and SNAPPE-II, by calculating receiver operating characteristic (ROC) curves and their associated area under the curve (AUC).Results761 infants were studied: 14.4% died and 4.1% survived with severe cerebral ultrasound findings. The aOR of severe adverse outcome for hypoproteinemia was 6.1 (95% CI 3.8–9.9). The rank order for variables, as assessed by AUCs and 95% CIs, in predicting outcome was: total plasma protein [0.849 (0.821–0.873)], SNAPPE-II [0.822 (0.792–0.848)], CRIB [0.821 (0.792–0.848)], SNAP-II [0.810 (0.780–0.837)] and CRIB-II [0.803 (0.772–0.830)]. Total plasma protein predicted severe adverse outcome significantly better than CRIB-II and SNAP-II (both p<0.05). Calibration for total plasma protein was very good.ConclusionsEarly hypoproteinemia has prognostic value for severe adverse outcome in very preterm, sick infants. Total plasma protein has a predictive performance comparable with CRIB and SNAPPE-II and greater than other validated severity scores.

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Section: Discussionmentioning

confidence: 98%

Total Plasma Protein in Very Preterm Babies: Prognostic Value and Comparison with Illness Severity Scores

et al. 2013

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“…In critically ill patients with increased vascular permeability, administration of albumin may actually worsen edema due to leakage of albumin into the interstitium with concomitant elevation of COP i and intensified accumulation of interstitial fluid. There is a correlation between low COP p at birth and severity of respiratory distress syndrome [ 30 ] and detection of early hypoproteinemia in sick preterm babies is associated with unfavorable outcome [ 31 ].…”

Section: Discussionmentioning

confidence: 99%

Interstitial Fluid Colloid Osmotic Pressure in Healthy Children

et al. 2015

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ObjectiveThe colloid osmotic pressure (COP) of plasma and interstitial fluid play important roles in transvascular fluid exchange. COP values for monitoring fluid balance in healthy and sick children have not been established. This study set out to determine reference values of COP in healthy children.Materials and MethodsCOP in plasma and interstitial fluid harvested from nylon wicks was measured in 99 healthy children from 2 to 10 years of age. Nylon wicks were implanted subcutaneously in arm and leg while patients were sedated and intubated during a minor surgical procedure. COP was analyzed in a colloid osmometer designed for small fluid samples.ResultsThe mean plasma COP in all children was 25.6 ± 3.3 mmHg. Arbitrary division of children in four different age groups, showed no significant difference in plasma or interstitial fluid COP values for patients less than 8 years, whereas patients of 8-10 years had significant higher COP both in plasma and interstitial fluid. There were no gender difference or correlation between COP in interstitial fluid sampled from arm and leg and no significant effect on interstitial COP of gravity. Prolonged implantation time did not affect interstitial COP.ConclusionPlasma and interstitial COP in healthy children are comparable to adults and COP seems to increase with age in children. Knowledge of the interaction between colloid osmotic forces can be helpful in diseases associated with fluid imbalance and may be crucial in deciding different fluid treatment options.Trial RegistrationClinicalTrials.gov NCT01044641

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“…COP p in healthy adults (25 mmHg) [ 17 , 23 ] is reported equal to children [ 14 ] but higher than in term [ 24 ]- and pre-term neonates [ 15 ] (20 mmHg and 15 mmHg, respectively). Sick neonates, regardless of maturity, have an even more decreased COP p [ 15 , 24 , 25 ]. Sussmane et al showed that COP p in healthy infants from 1 to 11 months is in proportion to adult values, with an anticipated COP p increase during the first month of life [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

Transcapillary fluid flux and inflammatory response during neonatal therapeutic hypothermia: an open, longitudinal, observational study

et al. 2018

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BackgroundTherapeutic hypothermia is neuroprotective in asphyxiated neonates by counteracting mechanisms contributing to brain injury. Although an initial increased permeability is part of an inflammatory reaction and thereby a natural healing process, an excessive endothelial permeability with edema formation may result in impaired hemodynamics. Reduced permeability may, however, benefit healing. Although plasma and interstitial colloid osmotic pressure are accessible and essential parameters for understanding fluid imbalance, the mechanisms of fluid exchange remain poorly understood. The potential influence of therapeutic hypothermia on plasma and interstitial colloid osmotic pressure, and the relationship between inflammatory markers and colloid osmotic pressure in asphyxiated neonates, was investigated.MethodsSeventeen neonates with moderate to severe hypoxic ischemic encephalopathy, born after 35 weeks gestation, received servo-controlled whole body cooling before 6 h of age, followed by gradual rewarming after 72 h. All infants were treated according to a national hypothermia protocol. Interstitial fluid in the skin was collected at 7, 13, 25, 49, and 73 h after birth by subcutaneous implantation of multifilamentous nylon wicks with 60 min of implantation time. Biomarkers of inflammation and colloid osmotic pressure were measured in serum and interstitial fluid.ResultsA modest decrease in serum and interstitial colloid osmotic pressure was measured, leaving an unaltered difference in colloid osmotic pressure gradient. A decline in mean arterial pressure was observed between 7 and 13 h of life, with a concomitant decrease in positive fluid balance within the same time frame. White blood cell count and leukocyte subclasses dropped significantly throughout treatment, with elevated interstitial interleukin (IL)-1α and decreased serum IL-1RA, IL-6, and IL-10 during treatment time points.ConclusionsColloid osmotic pressures measured in serum and interstitial fluid during asphyxia is lower than previously reported, with small alteration of pressure differences across capillaries, reducing vascular filtration. An inherent local and systemic regulation of inflammation together with changes in colloid osmotic pressure may indicate a possible preventive mechanism of edema generation during neonatal asphyxia and therapeutic hypothermia.Trial registrationClinicalTrials.gov Identifier: NCT01044940. Date of registration: January 8, 2010.

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Pression oncotique et détresse respiratoire néonatale

Cited by 9 publications

References 31 publications

Total Plasma Protein in Very Preterm Babies: Prognostic Value and Comparison with Illness Severity Scores

Total Plasma Protein in Very Preterm Babies: Prognostic Value and Comparison with Illness Severity Scores

Interstitial Fluid Colloid Osmotic Pressure in Healthy Children

Transcapillary fluid flux and inflammatory response during neonatal therapeutic hypothermia: an open, longitudinal, observational study

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