Skip to main content
PMC home page
Archives of Disease in Childhood logoLink to Archives of Disease in Childhood
. 1973 Oct;48(10):800–805. doi: 10.1136/adc.48.10.800

Early albumin infusion to infants at risk for respiratory distress

R D Bland, T L Clarke, L B Harden, Judith L Mayer, J P Ries, W A Madden, F W Crast, W F Coyer, J W Bass
PMCID: PMC1648558  PMID: 4749684

Abstract

In a randomized prospective study, 100 high-risk infants (selected on the basis of a cord serum protein level of 4·6 g/100 ml or less, gestational age under 37 weeks, birthweight 2500 g or less, and/or arterial pH below 7·25) received 8 ml/kg of either 25% salt-poor albumin or 5% dextrose in water before the age of 2 hours. All infants were then managed supportively with warmth, appropriate oxygen supplementation, isotonic fluid infusion, and close monitoring, without further administration of colloid or hypertonic alkali solutions over the first 4 hours of life.

No statistically significant difference was shown between early colloid and early dextrose-water administration for either the incidence of idiopathic respiratory distress syndrome (RDS) or the mortality of high-risk infants, suggesting no apparent advantage of albumin over simple glucose-water infusion to hypoproteinaemic newborns shortly after birth. However, among the infants of 28 weeks' gestation or less admitted to the study, 3 of 4 albumin-treated patients survived, while 5 comparable infants in the dextrose-water group died within 12 hours of birth.

For the 100 infants taken together there was a significant improvement in morbidity and mortality from previous experience in the same nursery, indicating that prompt supportive care, including early fluid administration, may be instrumental in reducing the incidence and severity of RDS.

Full text

PDF
803

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Adams F. H., Fujiwara T., Latta H. 'Alveolar' and whole lung phospholipids of premature newborn lambs. Correlations with surface tension, respiratory distress and pathology. Biol Neonate. 1971;17(3):198–218. doi: 10.1159/000240314. [DOI] [PubMed] [Google Scholar]
  2. BOUND J. P., HARVEY P. W., BAGSHAW H. B. Prevention of pulmonary syndrome of the newborn. Lancet. 1962 Jun 9;1(7241):1200–1203. doi: 10.1016/s0140-6736(62)92250-x. [DOI] [PubMed] [Google Scholar]
  3. Baum J. D., Eisenberg C., Franklin F. A., Jr, Meschia G., Battaglia F. C. Studies on colloid osmotic pressure in the fetus and newborn infant. With observations on the effects of membranes of various pore sizes. Biol Neonate. 1971;18(3):311–320. doi: 10.1159/000240371. [DOI] [PubMed] [Google Scholar]
  4. Chu J., Clements J. A., Cotton E. K., Klaus M. H., Sweet A. Y., Tooley W. H., Bradley B. L., Brandorff L. C. Neonatal pulmonary ischemia. I. Clinical and physiological studies. Pediatrics. 1967 Oct;40(4 Suppl):709–782. [PubMed] [Google Scholar]
  5. Emmanouilides G. C., Moss A. J. Respiratory distress in the newborn: effect of cord clamping before and after onset of respiration. Biol Neonate. 1971;18(5):363–368. doi: 10.1159/000240378. [DOI] [PubMed] [Google Scholar]
  6. FRAILLON J. M., KITCHEN W. H. The relationship between serum protein levels and hyaline membrane disease in premature babies. Med J Aust. 1962 Dec 15;49(2):941–942. doi: 10.5694/j.1326-5377.1962.tb24389.x. [DOI] [PubMed] [Google Scholar]
  7. GITLIN D., CRAIG J. M. The nature of the hyaline membrane in asphyxia of the newborn. Pediatrics. 1956 Jan;17(1):64–71. [PubMed] [Google Scholar]
  8. Gandy G., Jacobson W., Gairdner D. Hyaline membrane disease. I. Cellular changes. Arch Dis Child. 1970 Jun;45(241):289–310. doi: 10.1136/adc.45.241.289. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Hinkley C. M., Blechner J. N. Coloidal osmotic pressures of human maternal and fetal blood plasma. Am J Obstet Gynecol. 1969 Jan 1;103(1):71–72. doi: 10.1016/s0002-9378(16)34343-5. [DOI] [PubMed] [Google Scholar]
  10. Koenigsberger M. R. Judgment of fetal age. I. Neurologic evaluation. Pediatr Clin North Am. 1966 Aug;13(3):823–contd. doi: 10.1016/s0031-3955(16)31884-3. [DOI] [PubMed] [Google Scholar]
  11. Lauweryns J. M., Claessens S., Boussauw L. The pulmonary lymphatics in neonatal hyaline membrane disease. Pediatrics. 1968 May;41(5):917–930. [PubMed] [Google Scholar]
  12. NELIGAN G. A., OXON D. M., SMITH C. A. The blood pressure of newborn infants in asphyxial states and in hyaline membrane disease. Pediatrics. 1960 Nov;26:735–744. [PubMed] [Google Scholar]
  13. Naeye R. L., Harcke H. T., Jr, Blanc W. A. Adrenal gland structure and the development of hyaline membrane disease. Pediatrics. 1971 Apr;47(4):650–657. [PubMed] [Google Scholar]
  14. Oh W., Wallgren G., Hanson J. S., Lind J. The effects of placental transfusion on respiratory mechanics of normal term newborn infants. Pediatrics. 1967 Jul;40(1):6–12. [PubMed] [Google Scholar]
  15. RUDOLPH A. M., DRORBAUGH J. E., AULD P. A., RUDOLPH A. J., NADAS A. S., SMITH C. A., HUBBELL J. P. Studies on the circulation in the neonatal period. The circulation in the respiratory distress syndrome. Pediatrics. 1961 Apr;27:551–566. [PubMed] [Google Scholar]
  16. SAID S. I., AVERY M. E., DAVIS R. K., BANERJEE C. M., EL-GOHARY M. PULMONARY SURFACE ACTIVITY IN INDUCED PULMONARY EDEMA. J Clin Invest. 1965 Mar;44:458–464. doi: 10.1172/JCI105159. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. SILVERMAN W. A., ANDERSEN D. H. A controlled clinical trial of effects of water mist on obstructive respiratory signs, death rate and necropsy findings among premature infants. Pediatrics. 1956 Jan;17(1):1–10. [PubMed] [Google Scholar]
  18. SMITH C. A., PHILLIPS K. G., ROTH R. O. Effects and fate of human serum albumin administered intravenously and orally to premature infants. J Clin Invest. 1950 Feb;29(2):218–226. doi: 10.1172/JCI102249. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Starling E. H. On the Absorption of Fluids from the Connective Tissue Spaces. J Physiol. 1896 May 5;19(4):312–326. doi: 10.1113/jphysiol.1896.sp000596. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Usher R., McLean F., Scott K. E. Judgment of fetal age. II. Clinical significance of gestational age and an objective method for its assessment. Pediatr Clin North Am. 1966 Aug;13(3):835–contd. doi: 10.1016/s0031-3955(16)31885-5. [DOI] [PubMed] [Google Scholar]
  21. WOLF A. V., FULLER J. B., GOLDMAN E. J., MAHONY T. D. New refractometric methods for the determination of total proteins in serum and in urine. Clin Chem. 1962 Apr;8:158–165. [PubMed] [Google Scholar]

Articles from Archives of Disease in Childhood are provided here courtesy of BMJ Publishing Group

RESOURCES