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Biomedical subjects

K Beyreiss

Publications and source records attributed to K Beyreiss.

At least 37 records · Page 2Linked to original sources
PubMed1987

Improvements of metabolic imbalances after enteral sodium bicarbonate supplementation in infants of very low birth weight (VLBW).

One of the main points of clinical care is the catch-up growth of VLBW infants especially those of small gestational age (SGA). The required high amounts of protein are often not tolerated [1]. Metabolic imbalances due to immaturities of protein metabolism are described [2, 3] also in infants SGA feeding amounts of proteins comparable to mature newborns [4]. Remarkable signs of overloading by proteins are the elevation of amino acid and the bile acid concentrations in the serum [3, 5, 6]. In some of those cases [7] late metabolic acidosis (LMA) is to be seen. There is evidence in the literature that sodium bicarbonate influences nitrogen [8] and ionic balances [9] in newborn animals without any signs of acidosis, besides its simple buffer function. The aim of this study was to control changes of metabolic imbalances after bicarbonate supplementation before development of acidosis in predisposed infants. Therefore we determined parameters, which were significantly changed with LMA [6] during two feeding schedules: firstly, during bolus supplementation in infants feeding (2.0 +/- 0.4) g/kg BW.d protein and secondly during chronic supplementation of bicarbonate to (3.0 +/- 0.4) g/kg BW.d protein. In relation to the improvement of the nitrogen balance in growing lambs [7] we supposed comparable effect of bicarbonate on metabolic imbalances caused by protein overloading.

Bicarbonates↗
PubMed1987

Cholestasis in late metabolic acidosis of prematurely born infants.

Serum concentrations of bile acids and tyrosine were determined in 14 premature infants with late metabolic acidosis and in 13 comparable controls without acidosis (protein intake 2 g/kg X d). At the same time the bile acids and the catalytic activity concentrations of lipase and trypsin were estimated in the duodenal juice. The daily faecal excretion and the percentage of fat eliminated were measured. In 8 patients with late metabolic acidosis the duodenal studies were repeated one week after late metabolic acidosis. Infants with late metabolic acidosis showed significantly higher concentrations of bile acids and tyrosine in the serum than the controls (p less than 0.0005). In the duodenal juice the activities of lipase and trypsin and the concentration of bile acids--especially of dihydroxy bile acids--were decreased (p less than 0.001). The faecal excretion during late metabolic acidosis was significantly increased, with high percentage of fat. Eight days after late metabolic acidosis all duodenal parameters equalled the range of the control group. The relations between acidosis, cholestasis, and amino acid transport to the liver are discussed.

Acidosis↗
PubMed1987

The application of redissolved human milk lyophilisate for nutrition of very low birth weight infants.

In the second month of life the nitrogen and fat balances were studied in 21 very low birth weight infants fed with native human milk or redissolved human milk lyophilizate. Caused by fat losses during the lyophilization procedure and decreased fat absorption rate as consequence of heating of the milk before lyophilization, the available energy is significantly lower in infants fed with redissolved human milk lyophilizate than in those fed with native human milk. The reduced energy intake leads to a decreased protein utilization, as well as to a poor weight gain. In addition, hyperaminoacidaemia and hyperaminoaciduria appear in these infants. Thus, supplementation with medium-chain triglycerides must be recommended if redissolved human milk lyophilizate is used for feeding very low birth weight infants.

Body Weight↗
PubMed1987

Metabolic consequences of high protein intake in premature infants appropriate for gestational age.

The metabolic consequences of different levels of protein intake were studied in premature infants appropriate for gestational age (birth weight between 1500 and 2000 g) during the third week of life. The different protein intake was the result of different nutrition, human milk and two formulae containing 1.7 and 2.1 g protein/100 ml, respectively. The increasing protein intake causes an increase in the alpha-amino-nitrogen as well as the urea concentration in the serum, an elevation of total and alpha-amino-nitrogen losses in urine, increased amounts of stool accompanied by increased total nitrogen as well as fat excretion. The results indicate that a protein intake of more than 2.5 g/kg X 24 h creates a metabolic overloading without any advantages. Thus, human milk of mothers delivering preterm is a sufficient nutrition for these infants, also with regard to protein requirements, if feeding volumes of 180 to 200 ml/kg X 24 h are tolerated. Supplementation of human milk or nutrition with high protein formulae can be justified only in infants who cannot tolerate sufficient feeding volumes.

Amines↗
PubMed1987

[Sodium homeostasis in neonatal infection of eutrophic premature infants].

In 14 premature infants suffering from bacterial sepsis during the first week of life the daily renal sodium and potassium losses as well as the concentrations in serum of both electrolytes were measured before and during the period of infection. 24 hours before appearance of first clinical symptoms of sepsis the sodium concentration in urine increases and the balance becomes negative. Hyponatraemia occurs later and is in correlation with the clinical course of the disease. Thus, the hyponatraemia is caused more by shifting of sodium from the extracellular space than by renal sodium excretion. To prevent this hyponatraemia the sodium intake has to be increased to 6 mmol/kg X 24 h as a minimum and the fluid intake has to be decreased to 80 ml/kg X 24 h as a maximum in the same time when antibiotic treatment is started. A short-term control of serum electrolytes is an important premise for a sufficient treatment. Increased sodium concentrations in urine of more than 50 mmol/l or again increasing concentrations beyond the second day of life can be appreciated as early signs of neonatal sepsis.

Humans↗
PubMed1987

[Therapy of suspected intrauterine fetal retardation].

In a randomized prospective study, performed on 45 pregnancies with clinical and sonographic suspicion for intrauterine fetal growth retardation, examinations were done to evaluate the therapeutic effect of bed rest and of additional daily administered glucose infusions or oral galactose applications respectively on the fetal growth, the hemodynamic, respiratory and endocrine insufficiency of the materno-feto-placental unit as well as selected biochemical parameters of the umbilical blood. There is no positive therapeutic effect, either on the impaired endocrine partial function nor on the reduced respiratory function of the feto-placental unit. It is obvious, that despite the improvement of the nutritional supply of the fetus and the revival of the regular fetal growth, the previous lack of fetal growth can not be altered. This can be demonstrated in all three therapeutic groups due to the fact of a resulting high hypotrophy-rate of the newborns. The results prove that the additional supply of the fetus with glucose or galactose does not remarkably improve the therapeutic effectivity as opposed by strict bed rest alone.

Bed Rest↗
PubMed1986

Early onset lymphoedema, recessive form--a new form of genetic lymphoedema syndrome.

We report on two brothers with chronic congenital lymphoedema. Besides the oedemas of limbs we found an unusual facial appearance, abnormalities of external genitals as a deformation sequence resulting from intrauterine oedemas and intestinal lymphoedema. This X-linked or autosomal recessive trait may be a new entity, to be differentiated from other genetic lymphoedema syndromes, the so-called familial protein-losing enteropathy, and dominantly inherited intestinal lymphangiectasia. A prominent sign of the syndrome is chemosis and injection of conjunctiva.

Child↗
PubMed1986

Evidence for amino acid induced cholestasis in very-low-birth-weight infants with increasing enteral protein intake.

In the present investigation 32 very-low-birth-weight (VLBW) infants fed at three different levels of protein intake (2.92 g/kg/d from human milk, 3.22 and 4.06 g/kg/d from formula) were studied at the mean age of 21 days. Serum total alpha-amino nitrogen concentration correlated directly to total bile acid concentration. The serum and urine alpha-amino nitrogen and the serum bile acid concentration correlated with protein intake. The increase in protein intake was accompanied by a concomitant decrease in the intraluminal bile acid concentration in the AGA infants. The results offer indirect evidence of decreased bile flow in VLBW-infants on excessive oral protein intake. The cholestatic effect could be mediated by an increase in the plasma amino acid concentration.

Amino Acids↗
PubMed1986

Effects of bacterial sepsis on protein metabolism in infants during the first week.

In the presence of bacterial infection during the first week of life a catabolic state evolves more rapidly than in the later life. Hyperaminoacidaemia and subsequent hyperaminoaciduria, elevated urea concentrations in serum, and increased renal nitrogen losses are the most important metabolic changes. These findings correlate with the clinical course of the disease and refer to the primary disturbance of cell metabolism as the cause of the metabolic changes observed. While no relation could be observed between metabolic response and bacterial species, there is a significant dependence on the time interval from the occurrence of first clinical symptoms at the beginning of antibiotic treatment. If this period is longer than 8 h, serious metabolic disturbances will usually be found. Due to the limited amino acids utilization, especially by the liver, an adequate energy intake should be the primary aim of nutrition, whereas a protein intake of more than 2.0 to 2.5 g/kg X day may further aggravate the metabolic imbalance.

Bacterial Infections↗
PubMed1986

[Nutrition of very low birth-weight premature infants with enriched breast milk during the adjustment phase].

To enable an enteral nutrition in very low birth weight infants appropriate for gestational age, adapted to the high nutritional requirements, pooled human milk from mothers delivered preterm was enriched with human milk lyophilisate 6 g/100 ml. The concentrations of protein increase from 11.8 +/- 1.2 to 15.8 +/- 2.1 g/l and the non-protein energy substrates raise in the same proportion. Osmolality increases from 291.6 +/- 11.2 to 384.9 +/- 19.6 mosmol/l. The higher protein intake was tolerated without relevant metabolic imbalances. Only small increasing of amino acids concentrations in serum and a higher renal excretion of amino acids could be observed. The nitrogen balance was equalized during the first two days of life and positive from the 3rd day of life. Nitrogen retention was significantly higher in the group fed human milk lyophilisate enriched human milk from the 2nd day of life. Also the postnatal weight losses were significantly lower and the birth weight was reached significantly earlier. Human milk lyophilisate enriched human milk can be recommended for nutrition of very low birth weight infants appropriate for gestational age from the first day of life.

Amino Acids↗
PubMed1986

Influence of protein intake and liver function on acid base balance in premature infants.

In 43 patients with late metabolic acidosis (LMA) the factors promoting LMA were investigated. Postnatal adaptation was distributed in all cases, in 35 patients acidosis developed after introduction of formula feeding. Whereas no differences were observed in renal function (urine volume and renal molar excretion) between acidotic and non-acidotic patients, there was a significantly higher concentration of bile acids in serum (26.1 +/- 9.6 vs 98.6 +/- 21.6 mumol/l), a significantly increased fractional volume of stools (8.2 +/- 1.3 vs 11.4 +/- 1.9% of intake, and higher faecal fat excretion (26.5 +/- 5.2 vs 39.1 +/- 6.6% of faecal weight) in LMA patients than non-acidotic formula-fed infants. It is suggested that impaired postnatal development of liver function caused by severe disturbances of postnatal adaptation (respiratory distress, persistent fetal circulation, sepsis) is one of the most important factors in the pathogenesis of LMA. Thus, liver function should be checked before a protein intake surpassing that of a breastfed infant is introduced. Concentration of the serum bile acid level seems a reliable marker of LMA.

Acidosis↗
PubMed1986

[Nitrogen and lipid balances in newborn infants with low birth weight fed lyophilized breast milk of various composition].

Nitrogen and fat balance studies were performed in 6 low birth weight infants (average birth weight: 1465 +/- 128 g) who were alternatively fed 3 types of lyophilized human milk during the 5th through 14th week of life. Feeding group I received human milk (protein content 1.32%). Group II was administered concentrated human milk (protein content 1.69%). Group III received human milk fortified with whey from cow's milk (protein content 1.74%). Group II showed the best results with respect to weight gain, nitrogen balance and blood metabolites. The introduction of whey protein in Group III resulted in higher plasma levels of urea (p less than 0.05), threonine (p less than 0.05), valine (p less than 0.025), isoleucine (p less than 0.01), leucine (p less than 0.02) and lysine (p less than 0.001) compared with Group I infants. Accordingly, plasma levels of alpha-amino-nitrogen were elevated in Group III.

Amino Acids↗