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174
175
TABLE I
Number of Subjects, Average Birthweight, Gestational Age, Average Silverman's Score, and Respiratory Rate
at Different Ages, in the 3 Groups of Prematures Studied
Group
Normal
Tachypnoea
Mild RDS
No.
..
..
..
40
14
5
Birthweight
Gestational
Age
(wk.)
1*76
1-72
(1 13-2326)
2-02
34*5
33 6
(31-38)
(32-37)
(kg.)
(kg.)
(1 26-2-48)
(1-79-2-31)
(28-40)
1-6 Hours
7-24 Hours
25-48 Hours
49-72 Hours
73-96 Hours
___.___
RespRespRespRespRespScore iratory Score iratory Score iratory Score iratory Score iratory
Rate
Rate
Rate
Rate
Rate
08
56
06
52
05
51
02
48
46
02
1 4
1 2
71
69
1.1
66 0| 6
58
0D4
54
3-0
67
2-4
64
1.0
57
0-8
55
-
Results
The main clinical features of the infants studied
are summarized in Table I. There were no
appreciable differences in birthweight and gestational age between the first and the second group, while
in the third group the average birthweight was
slightly higher. The average respiratory rate in the
second and third group, and the Silverman's score
in the third group, were higher than normal in the
first two days of life and decreased gradually thereafter.
Samples from the right and left radial and
temporal arteries, and the umbilical artery, have
been analysed together because Moss et al. (1965)
have found no appreciable right-to-left ductal
shunts in similar infants.
176
TABLE II
Infants Studied at Different Ages (Means * SD)
Premature
in
'Normal'
Arterial Blood Values
3-5 Hr.
..
Number
..
Age (mean)
PaO2 (mm. Hg)
SaO2(%)
.*
VA(%)
..
..
..
..
4
4 hr.
59*5t
7-7
91 3t
1-7
19-5*
4-5
..
6-12 Hr.
9
8 hr.
69 7*
11-8
95-2*
1-2
14-5*
13-24 Hr.
12
20 hr.
67*Ot
15-2
95.3*
2-1
16-3*
7329*
0-038
4-8
7*425
0-072
6-3
7*464
0-064
47.3*
28*2t
27*2t
BE (mEq/l.)
3..
-37*
-7*
Hb(g./100ml.)
..
pH.
.
8-5
1-5
16*2t
1-7
6-9
3-1
16-lt
2-8
8-4
3-2 *
3-3
16 0*
2-3
100
90
bO
80
70-
25-48 Hr.
22
35 hr.
72*5t
20-9
950*t
5-10 Dy.
12
7*5 dy.
12-0
9-6
0-6
80.3*
2-0
1-5
95*7t
95 1*
1-3
13-8t
9-8*
5-5
7*425
0044
31.7*
6-7
8-2
4-5
7*378
0043
36*4
8-7
7*434
0054
31.3*
6-7
-3*
30
15*7*
2-4
t = p < 0-01,
11-40 Dy.
3-4 Dy.
13
73 hr.
77.8*
16-4
-9*
2-3
14-3
4-8
*
4-2
-
25*
2-3
13-3
1-8
8
27*5 dy.
77*8t
960Ot
8-4
2-9
7*425
Adults
13
30 yr.
91*8
12-4
97-1
1.1
5-5
5-1
7*443
0033
0044
32*9
40
6-4
-1*
2-2
10.9
30
37*9
+ 1*4
1-5
13 0
11
p < 0001.
50-
'
12
Hours
24
48 3 4
'
'
10 20 30 40
Days
Adults
Aqe
Discussion
The results of the present study are compared
with data derived from previous publications in
Table IV.
We have confirmed the presence of decreased
arterial oxygenation in the newborn period in
177
100-
*~~~~*s
95
00
@0
0*
4*
0*
00
;o
C1
c0
901
0*
85
6
-
Age
12
Hours
48 3_ i
'
24
-
0
'
20
30
Day s
40
50
Adults
FIG. 2.-Arterial oxygen saturation in 'normal' premature infants of different ages. Means + SD are shown.
307
25
20-
-0
cx
*
vs
10-
*-
%a
_r.
.__
0
'
12
Hours
24
*
0
SI-
.
.
.
.1
._
.,T
48
'
3 4
'
10
20
30
40
S0 Adults
Days
Aqe
FIG. 3.-Venous admixture in air of arterial blood in 'normal' premature infants of different ages. Means
SD are shown.
6
178
TABLE III
Arterial Blood Values in 3 Groups of Premature Infants Studied at Different Ages (Means SD)
..
Number ..
..
Age (mean)
P&O2 (mm. Hg) ..
SaO2() * -
VA(%)
..
..
..
Hb (g./100 ml.) ..
Tachypnoea
Tachypnoea
Normal
RDS
RDS
Normal
Tachypnoea
RDS
21
11
22
25
15 hr.
12-5 hr.
15 hr.
35 hr.
34-5 hr.
41 hr.
5-5 dy.
5-4 dy.
5-5 dy.
57*3
13-8
79*0
99
76*8
12-7
71*1
5-3
93.1*
95 *4
1-5
1-6
1-4
9 0
5 0
6-3
10 0
2-2
35-7
4-8
-39
2-5
9 7
3-1
7*398
0044
40*6
7-3
-19
3-4
13-8
3-6
14-3
1-8
14-4
1-2
68 2
13-4
95 2
1-7
156
5-7
7448
0-069
27-5
7-8
3-7
3-3
16-0
2-5
pH.
3-10 Dy.
25-48 Hr.
6-24 Hr.
Normal
58.7*
10-2
920*t
2-5
52.5*
72*5
12-4
20-9
59 *7
15-0
2-0
902*
95 *0
2-0
2-3
1 0
17-5
5-4
7*395
0-022
34-4
109
93*7
9 3
8-3
28-7t
13-8
8-7
18-9
7-5
7*380t
7*381
0-062
7*420
0-023
36-9t
33-2
7*434
0054
31-3
6-7
-2-3
30
15 7
2-4
21-4
0-022
7-3
5-3
2-8
16-2
0-2
7-1
3-7
2-1
155
2-3
309
3-7
3-5
2-2
3-7
2-6
14-1
1-4
14-3
1.0
94*8
94*8
7*402
0049
339
59
-3-2
7*378
0-038
Values significantly different from 'normal' of the same age: * = p < 005; t = p < 0 01; * = < 0 001.
present in the babies studied. Nelson and coworkers (1963) and Prod'hom and co-workers (1964)
have demonstrated, in newborn infants with a
higher birthweight, a large right-to-left shunt. On
the other hand, from the data of Moss and coworkers (1965), it can be calculated that a true rightto-left shunt cannot account completely for the low
P102 and S502 in premature infants breathing room
air; this implies that a ventilation-perfusion
imbalance (or possibly a diffusion defect) is also
present.
100
o-o Normal
* --.@CTachypnoea
30-
A----A
Resp.distress
1--~~~~~~~~~~~~~0
90-
20-
O--O Normal
10 -
*.-.--aTachypnoea
A----A
80-
0
Aqe (days)
II
Resp.distress
10
--I
3b
0
0
10
30
Aqe (days)
shown.
179
TABLE IV
Comparison of Present Data with Those Found by Other Authors in Normal Full-term and Premature
Newborn Infants
Author
Stahlman (1947)
(Femoral artery)
Birthweight
(kg.)
Gestation
(wk.)
No.
0.
Age
(hr.-dy.)
Pa02Hg)
(mm.
3 -23
(2*50-4*08)
Full-term
16-5 hr.
(9-22)
34 hr.
93 0
7-434
30 9
94*6
31 -3
29 -2
15
11
6
(29-48)
58 hr.
(50-72)
82 hr.
SaO2
(%
pH
PaCO2
(mm.
Hg)
94*6
92-9
7*424
7 429
7*465
94-7
93-2
7-341
7-408
38 -3
336
94*9
7*306
38-3
VA
(o
30*5
______________(75-96)
2-50
Full-term
7
14
3 *15
Full-term
17
(Left atrium)
(2*30-3*90)
6
27
6
20
7
(Umbilical artery)
3-18
(2*27-4*31)
36-5
(35-39)
36
6
20
19
14
2*02
(1 36-2*33)
6
15
20
7
Present data
1*76
(1 26-2 48)
34*5
(28-40)
4
21
22
25
8
3 hr.
24 hr.
2*6 hr.
(1-4)
7O-0hr.
(4-10)
1l hr.
(6-24)
38 hr.
(30-45)
45 hr.
(30-48)
97 hr.
(76-112)
86 hr.
(72-96)
85 *3
94*1
7*368
78 8
94*4
7 *386
87*0
94*5
7*379
7*390
34 -4
-
33 -9
-
5 dy.
1 hr.
94*9
61-0
7-310
36 -3
35 *2
46-0
31
4 hr.
24 hr.
72 *0
71-0
40*0
36-0
20
7 *370
7430
9 hr.
(2-12)
18 hr.
68*5
61*3
75 *9
77 7
94*0
93*5
94*7
94*3
7*376
7*391
7*394
32*7
29*8
29*3
17
16
7 356
31*9
11
59*5
91*3
7 *329
47 *3
20
15 hr.
68 *2
7*448
7*434
16
72 *5
95 *2
95 *0
27 *5
35 hr.
31*3
79*0
95 *4
77 8
96-0
7 *402
7-425
14
9
8
(13-24)
34 hr.
(25-48)
67 hr.
(49-120)
4 hr.
(3-5)
(6-24)
(25-48)
5-5 dy.
(3-10)
27-5 dy.
(11-40)
33*9
32-9
20
15
Summary
Arterial oxygen and carbon-dioxide tension (Pao2
and Paco2), pH, base excess, and Hb concentration
were measured in 59 premature infants from 3 hours
to 40 days of age and in 13 normal adults; oxygen
saturation (SaO2) and venous admixture in air (VA)
were also calculated. The babies were divided into
3 groups.
In a group of 40 'normal' prematures SaO2 did not
change appreciably after 5 hours of age, whereas
there was a significant rise in PaO2 and a fall in VA
from 6-24 hours to 3-10 days of life. PaO2 and SaO2
at all ages were significantly lower than in normal
adults.
180
Addendum
After this paper was accepted Thibeault, Clutario, and
Auld (1966) found similar results to ours.
RaRaENCa
Thibeault, D. W., Clutario, B., andAuld, P. A. M. (1966). Arterial
oxygen tension in premature infants. J. Pediat., 69, 449.