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Biomedical subjects

G Putet

Publications and source records attributed to G Putet.

At least 109 records · Page 6Linked to original sources
PubMed1983

Dietary composition and macronutrient storage in preterm infants.

A comparison has been made of the influence of feeding own mother's milk and formula on the oxidation and accretion of energy and macronutrients in the growing preterm infant of very low birth weight (less than 1,300 g) by using the combined techniques of nutrient balance and computerized indirect calorimetry. There were 22 studies in formula-fed infants and 15 studies in premature infants fed own mother's milk. Despite their lower metabolizable energy intake, the infants fed own mother's milk grew in weight, length, and head circumference at a rate approximating those of the formula-fed group. The metabolic rate was significantly lower in the infants fed own mother's milk (56.0 +/- 0.9 v 62.6 +/- 0.8 kcal/kg/d; P less than .001). The protein intake, oxidation, and accretion were similar in the two groups. The infants fed own mother's milk had a significantly lower fat intake (P less than .001), higher fat oxidation (P less than .025) and consequently lower fat accretion (P less than .001) than the formula-fed infants. The proportional fat content of the daily weight gain was lower in the infants fed own mother's milk (16% v 33%; P less than .001) but protein content was similar (13% v 12%). The accretion of energy, fat, and protein correlated with the respective metabolizable intakes in both groups (r = .81 to .98; P less than .001), suggesting that accretion rates and hence composition of weight gain are dependent on levels of energy and macronutrient intake.

Animals↗
PubMed1982

Influence of thermoregulation on energy metabolism of the low birthweight infant.

UNLABELLED: By combining continuous measurements and recordings of (a) 02 consumption and CO2 production, (b) core, mean skin and temperature, (c) "radiative and convective" (R + C) heat loss, we have tried to assess the characteristics and effiency of different heating systems in the usual environment of an intensive care unit. PRELIMINARY RESULTS: minimal heat loss is obtained in an incubator with manual temperature control versus serocontrolled incubator on radiant heater; the radiant heater can maintain adequate core temperature but with higher than normal heat loss from the sides of the body and increased warming only of the skin facing the heater; metabotic rate measurements do not show any statistical difference between these various environments; both with an incubator and a radiant heater, a thin plastic sheet (used as heatshield) lowers "R + C" heat loss.

Body Temperature Regulation↗
PubMed1982

[Continuous enteral feeding by nasoduodenal tube in premature infants with birth weight less than or equal to 1,200 g (author's transl)].

32 healthy or sick low birth weight infants (birth weight less than 1,200 g), surviving more than 48 hours with or without respiratory distress were fed by continuous enteral infusion of human milk through a nasoduodenal tube. By this method, oral caloric intake was increased quickly. This allowed early suppression of intravenous supplementation and lowered risks of metabolic and septic disorders. Precautions which are to be followed in order to lower intestinal complications are reported.

Body Weight↗
PubMed1982

Partition of energy metabolism and energy cost of growth in the very low-birth-weight infant.

Energy requirements are partitioned between needs for maintenance (including resting metabolism, thermoregulation, and muscular activity) and needs for synthesis and storage of new tissue. The partition of energy utilization was evaluated by 22 metabolic and nutritional balance studies in 13 formula-fed (SMA 20/24), growing, appropriate-for-gestational age, very low-birth-weight infants (mean +/- SE birth weight, 1,155 +/- 39 gm; study weight, 1,271 +/- 60 gm; age at study, 21 +/- 2 days; weight gain, 16.8 +/- 1 gm/kg/day). Continuous open-circuit, indirect calorimetry was performed for periods of 6 +/- 0.25 hours in a thermoneutral environment. Results expressed as mean kilocalories per kilogram per day (+/- SE) were: energy intake, 148.6 (+/- 3.9); stool and urine losses, 18.2 (+/- 1.5); metabolizable energy, 130.4 (+/- 3.5); "basal" metabolic rate, 47.0 (+/- 0.75); energy cost of activity, 4.3 (+/- 0.9); thermic effect of food, 11.3 (+/- 0.65); energy stored in new tissue, 67.8 (+/- 3.0). These results provide a partition of energy utilization in very low-birth-weight infants under thermoneutral conditions. Increased activity and a thermal environment outside the neutral range will augment maintenance energy requirements, thus decreasing the amount of energy available for growth if metabolizable energy intake remains constant. The energy cost of growth (ie, for synthesis of, and storage in, new tissue) was determined as 4.9 kcal/gm of weight gain. To attain the equivalent rate of intrauterine weight gain, a metabolizable energy intake of approximately 60 kcal/kg/day in excess of maintenance requirements of 51.3 kcal/dk/day must be provided.

Anthropometry↗
PubMed1981

Diet, fat accretion, and growth in premature infants.

To compare the growth and accumulation of protein, fat, and carbohydrate in the formula-fed premature infant and in the fetus of a similar postconceptional age, we performed 22 metabolic studies in 13 infants of very low birth weight (1155 +/- 39 g [mean +/- S.E.]). Measurements combining nutritional balance and indirect calorimetry demonstrated the deposition rates of protein and fat. We found that the formula-fed, very-low-birth-weight infant who gained weight comparably to the fetus retained the same amount of protein (1.92 +/- 0.1 g per kilogram of body weight per day) but accumulated fat at a rate of 5.4 +/- 0.3 g per kilogram per day - about three times that in the fetus, as confirmed by increased skin-fold thickness. How this change in body composition affects the future growth of formula-fed premature infants, and how body composition is altered by other dietary regimens such as the provision of human milk, remain to be determined.

Anthropometry↗
PubMed1981

Influence of postnatal age, energy intake, and weight gain on energy metabolism in the very low-birth-weight infant.

The relative importance and interrelationship of postnatal age, energy intake, and weight gain on metabolic rate is evaluated in 28 studies in 13 formula-fed very low-birth-weight AGA infants. The relationships between metabolic rate, energy intake, weight gain, and age all follow a similar pattern, increasing in the first two weeks of life and subsequently stabilizing. Significant linear correlations are demonstrated between metabolic rate and both energy intake (r = 0.88, P less than 0.001) and weight gain (r = 0.86, P less than 0.001). For each gram of weight gain, 0.67 kcal (2.8 kj) are expended in addition to the maintenance energy requirement of 51 kcal/kg/day. The increase in metabolic rate in the early postnatal period appears to be a consequence of the energy cost of tissue synthesis. Changes in metabolic rate with postnatal age are modulated by increasing energy intake and weight gain.

Age Factors↗
PubMed1981

Relation between heart rate and energy expenditure in the newborn.

This study defines the relationship between heart rate and metabolic rate in newborn infants and evaluates the accuracy of prediction of metabolic rate from heart rate. Continuous measurements of oxygen uptake, CO2 production, respiratory quotient, and cumulative heart rate were performed using computerized, open-circuit indirect calorimetry and on-line electrocardiogram monitoring over periods of 1 to 24 hr (mean 4.5 hr). Metabolic rate was calculated from the individual oxygen uptake and respiratory quotient. Thirty-five studies were performed in 16 infants (birthweight 0.75 to 3.1 kg; gestational age, 26 to 42 wk; mean +/- S.D. age at study, 26.5 +/- 15.7 days; study weight, 1.78 +/- 0.5 kg). Metabolic rate (cal/kg . min) and heart rate (beats/min) were compared minute by minute (8269 measurements) and showed a close third degree polynomial relationship for heart rates of 110 to 230/min (y = -0.0000291x3 + 0.01685x2 -2.93x + 197; r = 0.99; P less than 0.001); however, at heart rates above 140 beats/min, a linear relationship was found (r = 0.997; P less than 0.001). From cumulated heart rate measurements, factors defining metabolic rate per heart beat were also determined: for each beat 51.8 +/- 6.8 microliter of oxygen/kg are consumed and 0.258 +/- 0.03 cal/kg (1.1 J/kg) are expended. Despite the wide variation in birthweight, gestational age, method of feeding, and clinical characteristics, there was a remarkable consistency in the heart rate-metabolic rate relationships. A further 10 studies were performed in a similar group of infants to assess the predictive value of the previously defined relationships and showed a mean percentage deviation of 5.7 +/- 4% from the measured value. We conclude that in the varied group of newborns studied, heart rate correlates closely with metabolic rate and that cumulative heart rate measurements enable the estimation of metabolic rate in newborn infants. This provides a method of monitoring energy expenditure and caloric requirements over long periods.

Energy Metabolism↗
PubMed1981

Hypoparathyroidism during pregnancy: treatment with calcitriol.

A pregnant woman suffering from idiopathic hypoparathyroidism was treated with calcitriol [0.5-2 micrograms/day 1,25-dihydroxyvitamin D3 (1,25-(OH)2D3)]. Her twin infants were delivered by cesarian section at 37 weeks of gestation. Laboratory investigations in the perinatal period disclosed: 1) normal serum calcium and phosphorus levels in the mother, 2) normal babies with no clinical or biochemical signs of hyperparathyroidism, 3) a low serum level of 25-hydroxyvitamin D despite a normal serum level of 1,25-(OH)2D in the mother, and 4) a low level of 25-hydroxyvitamin D and a high level of 1,25-(OH)2D in cord serum in both infants. It is suggested that calcitriol is an effective treatment of hypoparathyroidism during pregnancy and produces no ill effects on the baby.

Adult↗
PubMed1979

[Severe urinary tract and cutaneous lesions after umbilical cord artery puncture and direct injection of hypertonic sodium bicarbonate to the newborn in the delivery room. Report of three cases (author's transl)].

Three cases of necrotizing and calcifying lesions of low urinary tract, buttock and adjacent perineum are reported. These lesions have been induced by direct syringe injection into an umbilical artery of 42% sodium bicarbonate solution at the dose of 5 to 6 ml/kg of body weight. Radiographic examinations are very important to study the urinary tract lesions. These have been surgically controlled in two cases. The follow up ranges from 10 to 21 1/2 months. On the bladder initial necrotizing lesions are followed by calcification and parietal retraction. These bladder lesions induce a more or less important ureterohydronephrosis. To these constant lesions are variably associated urethral calcifications and stenosis, distal ureter calcifications. These lesions seem to be related to the sodium bicarbonate hyperosmolality, to the injection conditions, and to the local hemodynamic features.

Bicarbonates↗
PubMedDate not supplied

Type of initial brainstem auditory evoked potentials (BAEP) impairment and risk factors in premature infants.

Brainstem auditory evoked potentials (BAEPs) were recorded in 89 premature infants aged between 34 and 52 weeks. 47.2% had normal and 52.8% abnormal BAEPs in at least one ear. Seven risk factors were taken into account: birth weight lower than 1500 g, hypoxia, neurological damage, fetal pathology, associated malformation, the use of ototoxic drugs, and exchange transfusion. The type of BAEP impairment was defined as either endocochlear, transmission or retrocochlear damage. Percentage BAEP impairment was higher in case of hypoxia (63.3%) but remained similar whether the other risk factors were present or absent. Transmission impairment was more frequent in case of birth weight lower than 1500 g, hypoxia or ototoxic drug administration; Endocochlear damage occurred more frequently when ototoxic drugs had been used or exchange transfusion performed. When birth weight was lower than 1500 g, transmission damage was more frequent than when birth weight was higher than 1500 g. In contrast, endocochlear damage was more frequent when birth weight was higher than compared with lower than 1500 g. In male infants, BAEP impairment was more frequent and more often of retrocochlear type than in female infants. BAEP impairment was more frequently of endocochlear type in female compared to male infants. Among the 89 premature infants recorded, 11.2% has endocochlear damage corresponding to potentially handicapping hearing loss. These results are discussed with reference to the literature.

Birth Weight↗
PubMedDate not supplied

Effects of calcium and phosphorus supplementation on calcium retention and fat absorption in preterm infants fed pooled human milk.

Fat, phosphorus, and calcium balance studies were performed in normal very low birth weight infants (BW less than or equal to 1,500 g) fed either normal or calcium- and phosphorus-supplemented pooled pasteurized human milk. Calcium and phosphorus supplements were 27 mg/dl and 24.5 mg/dl, respectively, throughout the study. Measured calcium and phosphorus intake in the supplemented group averaged 90 +/- 6 mg/kg/day and 62 mg/kg/day, respectively, compared to 47 +/- 7 mg/kg/day and 24 +/- 6 mg/kg/day in the nonsupplemented group. The percent of fat, calcium, and phosphorus absorption was similar in the two groups: respectively, 71 +/- 23%, 73 +/- 13%, and 93 +/- 2% in the supplemented group compared to 75 +/- 11%, 71 +/- 14%, and 92 +/- 4% in the nonsupplemented group. Calcium and phosphorus retention reached 62 +/- 12 mg/kg/day and 53 +/- 4 mg/kg/day in the supplemented group against 21 +/- 10 mg/kg/day and 21 +/- 5 mg/kg/day in the nonsupplemented group. These data support the notion that calcium, in addition to phosphorus supplementation in pooled human breast milk, improves both calcium and phosphorus retention in preterm infants.

Calcium↗
PubMedDate not supplied

Respiratory and metabolic ultradian (40 min<period<6h) variations in normal premature infants periodically fed through a gastric tube.

Oxygen consumption (VO2) and carbon dioxide emission (VCO2) have been continuously recorded for 24 consecutive hours in 7 premature infants with a range of gestational age of 29-31 weeks at birth, and placed in incubators within a thermal neutral limit. These infants, submitted to continuous light, were fed every 3-4h through a gastric tube which was left in their stomachs throughout the whole experiment. Variance and spectral analyses performed on VCO2 values sampled on the recordings every 10 min showed ultradian variations, in the 40 min-6 h period range, which represent 20 and even 40% of the mean level. Moreover 5 out of the 7 premature infants show ultradian VCO2, VO2 and respiratory quotient rhythms related to feeding frequency.

Activity Cycles↗
PubMedDate not supplied

[Cesarean section before the end of 32 weeks' gestation. Apropos of 91 neonatal case reports].

78 cesarean sections (CS) were performed before 32 weeks of gestation over a period of six years in a obstetric clinic; 91 premature infants were born; the rate of CS at this period of time represented 0,47% of total birth. 84 premature infants were transferred to the neonatal unit located in the same clinic; 3 were dead in utero and 4 just after delivery. 69 infants survived (78%) but 6 had severe sequelae (spastic diplegia, epilepsy and RLF) at one year of age and 7 had minor sequelae.

Birth Weight↗