heroin and Infant--Premature--Diseases

Topics: Apgar Score; Behavior; Blood; Brain; Brain Chemistry; Central Nervous System; Child Development; DNA; Embryonic and Fetal Development; Female; Fetus; Gestational Age; Heroin; Hormones; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Infant, Premature, Diseases; Lysergic Acid Diethylamide; Mother-Child Relations; Neurologic Examination; Neurologic Manifestations; Placentation; Pregnancy; Tranquilizing Agents; Umbilical Cord

To determine physiological and hormonal stress responses in ventilated preterm infants.. Physiological and hormonal stress responses were studied in 47 ventilated preterm infants who were judged clinically to require sedation. The correlation between the stress response and severity of illness was examined, and responses were compared between infants with different clinical outcomes.. Stress hormone concentrations were significantly correlated with severity of illness, assessed using the arterial: alveolar oxygen partial pressure ratio. Noradrenaline showed the strongest correlation, with an exponential pattern of increased secretion. Catecholamine concentrations before sedation were significantly higher among infants who subsequently died (n = 15, at a median age of 6 days) than among survivors: median noradrenaline 4.31 vs 2.16 nmol/l, median adrenaline 0.69 vs 0.31 nmol/l. The observed fall in noradrenaline with sedation was lower among those who died than survivors (median fall 2% vs 40%).. Preterm infants are capable of hormonal stress responses appropriate for the severity of their illness. Extreme catecholamine responses, in the sickest infants, are associated with the worst outcome.

Topics: Epinephrine; Female; Heroin; Humans; Hydrocortisone; Infant, Low Birth Weight; Infant, Newborn; Infant, Premature; Infant, Premature, Diseases; Male; Norepinephrine; Respiration, Artificial; Stress, Physiological

The effects of diamorphine were studied in 34 premature neonates who were given a loading dose of 50 micrograms/kg of diamorphine followed by a constant rate intravenous infusion of 15 micrograms/kg/hour. Small but significant falls were noted in blood pressure (at 30 minutes) and heart rate (at 30 minutes, six hours, and 12 hours) after administration of diamorphine, but these did not appear to cause any clinical deterioration and were thought to be related to the sedative effect of the drug. A significant fall in respiration rate at 30 and 60 minutes reflected the desired intention to encourage synchronisation of the infants' breathing with the ventilator. The mean (SD) plasma concentration of morphine measured during the infusion at steady state was 62.5 (22.8) ng/ml (range 20 to 98 ng/ml). The data suggest that this dosage regimen of diamorphine is safe. It results in plasma concentrations of morphine in the premature neonate which are comparable with those that are known to provide effective analgesia in the child and adult.

Topics: Analgesia; Blood Pressure; Drug Administration Schedule; Heart Rate; Heroin; Humans; Infant, Newborn; Infant, Premature; Infant, Premature, Diseases; Infusions, Intravenous; Morphine; Respiration

Topics: Acetylcholine; Birth Weight; Central Nervous System; Epinephrine; Female; Gestational Age; Heroin; Humans; Infant, Newborn; Infant, Premature, Diseases; Nicotine; Pregnancy; Pregnancy Complications; Substance Withdrawal Syndrome; Substance-Related Disorders; Sweat Glands; Sweating

Topics: Barbiturates; Cannabis; Codeine; Female; Heroin; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Infant, Premature, Diseases; Maternal-Fetal Exchange; Methamphetamine; Narcotics; Pregnancy; Pregnancy Complications; Substance-Related Disorders; Toxicology