Search PubMed⌕ Search

Biomedical subjects

B H Wilkins

Publications and source records attributed to B H Wilkins.

12 recordsLinked to original sources
PubMed1997

Circumcision blues.

Explore the source record for details and available documents.

Anesthetics, Local↗
PubMed1992

The glomerular filterability of polyfructosan-S in immature infants.

Gel chromatography was performed on 21 plasma, 5 urine and 3 spinal fluid samples from pre-term infants who had received intravenous polyfructosan-S (PF-S), in order to investigate whether all sizes of PF-S molecule are filtered at the glomerulus and penetrate deep extra-cellular fluid compartments. Plasma obtained after 24 h continuous infusion of PF-S had identical chromatograms to the aqueous solution, suggesting no glomerular hold-up of the largest molecules. PF-S had a broader chromatogram than inulin, suggesting that it has larger molecules. Urine and plasma samples obtained early after a single injection had an excess of high molecular weight polyfructoside, suggesting that small molecules penetrate deep extracellular fluid compartments more easily. Spinal fluid samples had an excess of low molecular weight polyfructoside, suggesting slow penetration of the largest molecules.

Chromatography, Gel↗
PubMed1992

A reappraisal of the measurement of glomerular filtration rate in pre-term infants.

Thirty-seven single-injection polyfructosan-S (PF-S, Inutest) and 98 continuous-infusion PF-S/creatinine clearance studies were performed in 39 sick very low birth weight infants. The single-injection clearance method for measuring glomerular filtration rate has been shown to be a reliable technique if sampling is continued for 8 h or more and the PF-S (Inutest) assay is sensitive, accurate and precise. The continuous-infusion clearance method is also valid if the infusion is continued for more than 24 h and preceded by a loading dose in the form of a double-rate infusion for 8 h. Creatinine clearance is usually less than PF-S clearance, the mean ratio being 0.91, suggesting that there is some creatinine reabsorption in the renal tubule in sick very low birth weight infants.

Creatinine↗
PubMed1992

Renal function in sick very low birthweight infants: 1. Glomerular filtration rate.

A total of 135 measurements of polyfructoside clearance as a measure of glomerular filtration rate (GFR) were made in 39 infants of 25.5-33 weeks' gestation, birth weight 720-2000 g, between the ages of 0.5 and 33 days. GRF was related to postconceptional age and increased exponentially from geometric mean 0.59 ml/min at 26 weeks' postconceptional age to 1.40 ml/min at 33 weeks. GFR in the first week and GFR at later ages were the same for a given postconceptional age. GFR was the same in sick infants with severe ventilatory failure as in less ill infants. There was no evidence that GFR was influenced by nitrogen input. GFR increases postnatally in a preprogrammed way irrespective of other postnatal events. When factored by body weight GFR in the first week increased only little from arithmetic mean 0.70 ml/min/kg at 26 weeks to 0.84 ml/min/kg at 33 weeks, but older infants often had a falsely high GFR per kg when they lost weight in the first week or two after birth or failed to gain weight later.

Birth Weight↗
PubMed1992

Renal function in sick very low birthweight infants: 2. Urea and creatinine excretion.

Plasma urea and creatinine concentrations and urea and creatinine clearances and excretion were measured in a sample of 40 infants of 25.5-33 weeks' gestation, birth weight 720-2000 g, between the ages of 0.5 and 33 days. Creatinine excretion rate was between 60 and 120 mumol/kg/day in the first five postnatal weeks (mean 90.5) and was independent of sex or growth retardation. This can be used in clinical practice to estimate instantaneous urine flow rate V, if the creatinine concentration is measured in a randomly voided urine sample, from the formula V = 90.5/urine creatinine, with 95% confidence limits +/- 39%. There is a wide range of plasma creatinine at all gestations and ages decreasing from range 75-130 mumol/l in the first two days to 35-80 mumol/l at 3 weeks of age. Plasma urea is a poor indicator of glomerular filtration rate (GFR) in sick preterm infants. GFR (ml/min/kg) can be estimated from plasma creatinine from the formula GFR = 69.2/plasma creatinine but this estimate is imprecise with 95% confidence limits +/- 46%. Urea:creatinine clearance ratio was usually less than 1.0 (range 0.18 to 1.5) and was lower when the urine flow rate was low. Urea excretion was up to 17 mmol/kg/day in the first two weeks, higher in the more immature infants. These high levels were paralleled by a high plasma urea concentration, up to 18 mmol/l. A high plasma urea is not necessarily associated with renal failure or dehydration.

Creatinine↗
PubMed1992

Renal function in sick very low birthweight infants: 3. Sodium, potassium, and water excretion.

Renal excretion of sodium, water, and potassium was measured on 434 occasions in a sample of 40 infants of 25.5-33 weeks' gestation, birth weight 720-2000 g, between the ages of 0.5 and 36 days. Water excretion varied between 1% and 30% of the glomerular filtration rate, or 15-350 ml/kg/day, and varied widely from day to day in individual infants. Nearly all infants became hyponatraemic before or after the first postnatal week. There were a few instances of hypernatraemia in the first week caused by high insensible water loss. There were high levels of sodium excretion up to 16% of filtered sodium, or 21 mmol/kg/day, in the first two postnatal weeks. Highest levels of sodium excretion were seen in the most immature infants in the first week. In most infants sodium excretion increased either in the first week or later before a subsequent decline. Potassium excretion was often high in the first week, as much as 96% of filtered potassium, or 5 mmol/kg/day, and is associated with early hyperkalaemia.

Body Water↗
PubMed1992

Renal function in sick very low birthweight infants: 4. Glucose excretion.

Renal glucose excretion was measured on 239 occasions in a sample of 36 infants of 25.5-33 weeks' gestation, birth weight 720-2000 g, between the ages of 0.5 and 32 days. Glucose was invariably present in urine from the first day. Fractional glucose excretion varied widely from 0.1% to 90% of filtered glucose and glucose excretion rate was up to 15.5 mmol/kg/day and was higher in the most immature infants, especially below 28 weeks' gestation. The highest values were in association with hyperglycaemia between 5 and 15 days but there was no consistent plasma glucose threshold with frequent glucose spillage at normal blood glucose concentrations. There was some correlation with sodium excretion in the first week suggesting that in the absence of hyperglycaemia with a normal filtered glucose load, glucose excretion is caused by proximal tubular immaturity.

Blood Glucose↗