Central–peripheral temperature difference, blood pressure, and arginine vasopressin in preterm neonates undergoing volume expansion
- aDepartment of Child Health, University of Newcastle upon Tyne, bDepartment of Medicine, cDepartment of Paediatric Nephrology, Royal Victoria Infirmary, Newcastle upon Tyne
- Dr H J Lambert Department of Child Health Royal Victoria Infirmary Newcastle upon Tyne NE1 4LP.
- Accepted 5 August 1997
Abstract
AIM To examine the effect of intravascular volume expansion for the treatment of hypovolaemia in sick preterm neonates.
METHODS An intravenous infusion of 20 ml per kg of 4.5 % albumin was given to 14 preterm neonates. The effects on systolic blood pressure, central peripheral temperature difference (c-pT), and plasma arginine vasopressin concentration (pAVP) were measured.
RESULTS Thirteen babies showed a rise in systolic blood pressure. The six babies with the highest initial values of pAVP and c-pT showed a fall in both of these after infusion. The babies with lower initial pAVP (below 4 pmol/l) showed either a rise (two) or no change (six) after albumin infusion. There was a significant correlation between c-pT and log pAVP before (r2=0.61; p<0.05) and after infusion (r2=0.45; p<0.05).
CONCLUSIONS Plasma AVP concentration is related to c-pT in unwell preterm newborns. This study suggests that clinical assessment of hypovolaemia in preterm newborns is poor and could be improved by using c-pT.
- hypovolaemia
- albumin
- central peripheral temperature
- plasma arginine vasopressin
- systolic blood pressure
