Skip to main content
Log in

Untersuchungen über die postnatale Regulation des Säure-Basen-Stoffwechsels bei gesunden Frühgeborenen

  • Published:
Zeitschrift für Kinderheilkunde Aims and scope Submit manuscript

Summary

In 67 healthy prematures the actual pH, the actual pCO2, the standard bicarbonate and the base excess have been examined by the Astrup method. The examinations were done at the first day of life, partly also during the following 4 days.

The most marked shift in the acid-base equilibrium occurs during the first 4 hours of life. The respiratoric acidosis was compensated after 4 hours, the metabolic acidosis during the first 24 hours. From the 2. to the 5. day of life there were no marked disturbances in the acid-base metabolism.

For prophylaxis and therapy of the respiratory distress syndrome the acid-base metabolism of all prematures should be examined during the first days of life as a routine.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

Literatur

  1. Alvarez de Los Cobos, J., E. Jurado-Garcia, R. Josefina Sagaon, and V. Enriqueta Leon: Respiratory problems of the premature infant. III. Ann. Paediat. Fenn. 3, 118–130 (1957).

    Google Scholar 

  2. Astrup, P.: A simple electrometric technique for the determination of carbon dioxide tension in blood and plasma, total content of carbon dioxide in plasma, and bicarbonate content in “separated” plasma at a fixed carbon dioxide tension (40 mm Hg). Scand. J. clin. Lab. Invest. 8, 33–43 (1956).

    Google Scholar 

  3. —: Erkennung der Störung des Säure/Base-Stoffwechsels und ihre klinische Bedeutung. Klin. Wschr. 35, 749–753 (1957).

    Google Scholar 

  4. Astrup, P.: Ultra-Mikromethoden zur Bestimmung von pH, pCO2 und Standardbicarbonat im Kapillarblut. Vorlesung anläßlich der Londoner Tagung des Ciba Foundation Research Forums “Säure-Basen-Ausgleich” — 2. und 3. 12. 1959. Sonderdruck (deutsche Übersetzung) der Firma RADIOMETER Copenhagen.

  5. Astrup, P., K. Jørgensen, O. Siggaard-Andersen, and K. Engel: The acid-base metabolism. A new approach. Lancet 1960/I, 1035–1039.

  6. Bartels, O., u. J. Wenner: Standardbicarbonat, pH und CO2-Druck im “arterialisierten” Blut gesunder Säuglinge nach der Neugeborenenperiode bis zum Ende des ersten Lebensjahres. Klin. Wschr. 43, 437–440 (1965).

    Google Scholar 

  7. Beer, R., H. Bartels u. H. A. Raczkowski: Die Sauerstoffdissoziationskurve des fetalen Blutes und der Gasaustausch in der menschlichen Plazenta. Pflügers Arch. ges. Physiol. 260, 306 (1955).

    Google Scholar 

  8. Bell, W. B., L. Cunningham, and M. Jowett: The metabolism and acidity of the fetal tissues and fluids. Brit. Med. J. 1928/I, 126.

  9. Blystad, W.: Blood gas determinations on premature infants. I. Investigations of premature infants without respiratory complications. Acta paediat. (Uppsala) 45, 13–23 (1956).

    Google Scholar 

  10. —: Blood gas determinations on premature infants. II. Investigations of premature infants with early neonatal dyspnoe (The hyaline membrane syndrome). Acta paediat. (Uppsala) 45, 103–113 (1956).

    Google Scholar 

  11. Branning, W. S.: The acid-base balance of premature infants. J. clin. Invest. 21, 101–105 (1942).

    Google Scholar 

  12. Cornelissen, P., H. van Ravensteyn, H. Oving en W. Tegelaers: Het “respiratory distress” syndroom bij prematuren. Maandschr. Kindergeneesk. 31, 273 (1963).

    Google Scholar 

  13. de Rudder, B.: Vorschläge zur Vergleichbarkeit von Frühgeborenen-Statistiken. Dtsch. med. Wschr. 85, 1705–1707 (1960).

    Google Scholar 

  14. Eastman, N. J., and C. M. McLane: The lactic acid content of umbilical cord blood under various conditions. Bull. Johns Hopk. Hosp. 48, 261 (1931).

    Google Scholar 

  15. Erb, W.: Zur Entwicklungsgeschichte der rothen Blutkörperchen. Arch. path. Anat. (Berlin) 34, 138 (1865).

    Google Scholar 

  16. Fischer, W. M., u. W. Toussaint: Über den Säure-Base-Haushalt beim Neugeborenen: Untersuchungen in den ersten Lebensminuten. Arch. Gynäk. 199, 182–198 (1963).

    Google Scholar 

  17. Gambino, S. R.: Comparisons of pH in human arterial, venous and capillary blood. Amer. J. clin. Path. 32, 298–300 (1959).

    Google Scholar 

  18. —: Collection of capillary blood for simultaneous determination of arterial pH, CO2 content, pCO2, and oxygen saturation. Amer. J. clin. Path. 35, 175–183 (1961).

    Google Scholar 

  19. Gamp, R., u. Th. Koller jr.: Die Neugeborenen-Acidose und ihre Behandlung. Gynaecologia (Basel) 158, 164 (1964).

    Google Scholar 

  20. Gandy, G., L. Grann, N. Cunningham, K. Adamson jr., and L. St. James: The validity of pH and pCO2 measurements in capillary samples in sick and healthy newborn infants. Pediatrics 34, 192–197 (1964).

    Google Scholar 

  21. Gidion, R.: Neue Wege in der Behandlung des Dyspnoe-Syndroms. Vortrag 3. Frühjahrstagung der Deutschen Gesellschaft für Klinische Medizin Sektion Pädiatrie in Rostock-Warnemünde am 23. und 24. 4. 1965.

  22. Graham, B. D., M. U. Tsao, M. L. Baumann, and S. Brown: Development of neonatal electrolyte homeostasis. Pediatrics 8, 68 (1951).

    Google Scholar 

  23. — and J. L. Wilson: Chemical control of respiration in newborn infants. Amer. J. Dis. Child. 87, 287 (1954).

    Google Scholar 

  24. Gregg, R. H., and J. Bernstein: Pulmonary hyaline membranes and the respiratory distress syndrome. Amer. J. Dis. Child. 102, 871–890 (1961).

    Google Scholar 

  25. Hendricks, C. H.: Studies on lactic acid metabolism in pregnancy and labor. Amer. J. Obstet. Gynec. 73, 492–506 (1957).

    Google Scholar 

  26. Henschler, D.: Trispuffer als Therapeuticum (THAM). Dtsch. med. Wschr. 88, 1328–1331 (1963).

    Google Scholar 

  27. Himwich, H. E., F. A. D. Alexander, and J. F. Fazekas: Tolerance of the newborn to hypoxia and anoxia. Amer. J. Physiol. 133, 327 (1941).

    Google Scholar 

  28. A. C. Bernstein, H. Herrlich, A. Chesler, and J. F. Fazekas: Mechanism for the maintenance of life in the newborn during anoxia. Amer. J. Physiol. 135, 387 (1942).

    Google Scholar 

  29. Hutchison, J., M. Kerr, M. McPhail, T. Douglas, G. Smith, J. Norman, and E. Bates: Studies in the treatment of the pulmonary syndrome of the newborn. Lancet 1962/II, 465.

  30. —— T. Douglas, J. Inall, and J. Crosbie: A therapeutic approach in 100 cases of the respiratory distress syndrome of the newborn infant. Pediatrics 33, 956 (1964).

    Google Scholar 

  31. Iversen, T., and B. Zachau-Christiansen: Treatment of acidosis in respiratory distress syndrome. 14. Northern Paediatric Congress, Stockholm 21.–24. 6. 1964. Acta paediat. scand. Suppl. 159, 63 (1965).

    Google Scholar 

  32. Jarre, W., W. Ketterle u. H. Reinwein: Zur Behandlung des Respiratory-Distress-Syndrome bei Frühgeborenen mit Tris-(hydroxymethyl)-aminomethan (THAM) und Netzmittel. Helv. paediat. Acta 20, 27–39 (1965).

    Google Scholar 

  33. Jørgensen, K., and P. Astrup: Standard bicarbonate, its clinical significance, and a new method for its determination. Scand. J. clin. Lab. Invest. 9, 122–132 (1957).

    Google Scholar 

  34. Kaplan, S., R. Phyllis Fox, and L. C. Clarc jr.: Amine buffers in the management of acidosis. Study of respiratory and mixed acidosis. Amer. J. Dis. Child. 103, 4–9 (1962).

    Google Scholar 

  35. Kellner, R., W. Heine u. H. Becker: Vergleichende klinische und pathologisch-anatomische Untersuchungen über den Effekt der Azidosebehandlung beim “respiratory distress syndrome” der Frühgeborenen. Pädiatrie und Grenzgebiete. 5, 255–266 (1966).

    Google Scholar 

  36. Kellner, R., Vortrag Ausbildungslehrgang für Kinderärzte in Rostock vom 11. bis 15. 10. 1965.

  37. Keuth, U.: Das Syndrom der pulmonalen hyalinen Membranen der Neu- und Frühgeborenen. Med. Habilitationsschrift, Köln 1962.

    Google Scholar 

  38. — u. F. Adenauer: Untersuchungen über die Wirksamkeit von Alkali-Glucose-Infusionen bei der protrahierten Acidose der Früh- und Neugeborenenkrankheit der pulmonalen hyalinen Membranen. Z. Kinderheilk. 88, 244–254 (1963).

    Google Scholar 

  39. —: Atemstörungen des Neugeborenen. Pädiat. Prax. 3, 555–564 (1964).

    Google Scholar 

  40. Kildeberg, P.: Disturbances of hydrogen ion balance occurring in premature infants. I. Early types of acidosis. Acta paediat. (Uppsala) 53, 505–516 (1964).

    Google Scholar 

  41. Knudsen, E. J., and P. Hansen: Carbon dioxide tensions in non-arterialized capillary and arterial blood during anaesthesia. Acta anaesth. scand. 6, 29–35 (1962).

    Google Scholar 

  42. Maas, A. H. J., and A. N. P. van Heijst: A comparison of the pH of arterial blood with arterialised blood from ear-lobe with Astrup's Micro Glasselektrode. Clin. chim. Acta 6, 31–33 (1961).

    Google Scholar 

  43. ——: The accuracy of the micro-determination of the pCO2 of blood from the ear-lobe. Clin. chim. Acta 6, 34–37 (1961).

    Google Scholar 

  44. Mennicken, U.: Untersuchung von Standardbicarbonat, pH und pCO2 im Capillarblut Neugeborener. Med. Dissertation, Köln 1964.

  45. Moss, A. J., G. C. Emmanouilides, F. H. Adams, and Katok Chuang: The effect of hypoxia and status of ductus arteriosus in newborn infants. J. Pediat. 65, 819–823 (1964).

    Google Scholar 

  46. Ofteringer, K., u. R. Schreier: Der Einfluß einer zusätzlichen Flüssigkeitszufuhr auf den Säure-Basenhaushalt Neugeborener. Vortrag 62. ord. Versamml. d. Dtsch. Ges. f. Kinderheilk., München 1964. Mschr. Kinderheilk. 113, 241–243 (1965).

    Google Scholar 

  47. Oliver jr., T. K., J. A. Bates, and G. D. Bates: Serial blood-gas tensions and acid-base balance during the first hour of life in human infants. Acta paediat. (Uppsala) 50, 346–360 (1961).

    Google Scholar 

  48. Österlund, K.: A comparative investigation of the concentration of certain elektrolytes in maternal and cord blood. Ann. Paediat. Fenn. 1, Suppl. 4 (1954).

  49. Prystowsky, H., A. E. Hellegers, and P. Bruns: Fetal blood studies. XV. The carbon dioxide concentration gradient between the fetal and maternal blood of humans. Amer. J. Obstet. Gynec. 81, 372 (1961).

    Google Scholar 

  50. Räihä, C. E.: Über einige Neugeborenenprobleme. Acta paediat. (Uppsala) 28, 390 (1941).

    Google Scholar 

  51. Reardon, H. S., B. D. Graham, J. L. Wilson, M. L. Baumann, M. U. Tsao, and M. Murayama: Studies of acid base equilibrium in premature infants. Pediatrics 6, 753–771 (1950).

    Google Scholar 

  52. M. L. Baumann, and E. J. Hadstad: Chemical stimuli of respiration in the early neonatal period. J. Pediat. 57, 151–170 (1960).

    Google Scholar 

  53. Reich, J., u. J. Grimm: Die Wirkung oraler Natriumbicarbonat- und Glucosegaben auf die Azidose Frühgeborener während der ersten 10 Lebenstage. Kinderärztl. Prax. 33, 105–108 (1965).

    Google Scholar 

  54. Rosenbaum, S.: Das “Respiratory distress syndrome” des neugeborenen. Fortschr. Med. 81, 778–780 (1963).

    Google Scholar 

  55. Siggaard-Andersen, O., K. Engel, K. Jørgensen, and P. Astrup: A micromethod for determination of pH, carbon dioxide tension, base excess and standard bicarbonate in capillary blood. Scand. J. clin. Lab. Invest. 12, 172–176 (1960).

    Google Scholar 

  56. —— A new acid-base nomogramm. An improved method for the calculation of the relevant acid-base data. Scand. J. clin. Lab. Invest. 12, 177–186 (1960).

    Google Scholar 

  57. — A graphic represendation of changes of the acid-base status. Scand. J. clin. Lab. Invest. 12, 311–314 (1960).

    Google Scholar 

  58. — Sampling and storing of blood for determination of acid-base status. Scand. J. clin. Lab. Invest. 13, 196–204 (1961).

    Google Scholar 

  59. — The pH-log pCO2 blood acid- base nomogramm revised. Scand. J. clin. Lab. Invest. 14, 598–604 (1962).

    Google Scholar 

  60. — The acid-base status of the blood. Sec. Ed. Kopenhagen: Munksgaard 1964.

    Google Scholar 

  61. Schreier, K., u. R. Dankwart: Über den Brenztraubensäuregehalt des Blutes während der ersten Lebensstunden. Klin. Wschr. 29, 263 (1951).

    Google Scholar 

  62. Stahlman, M.: Treatment of cardiovascular disorders of the newborn. Pediat. Clin. N. Amer. 11, 363 (1964).

    Google Scholar 

  63. Strang, L. B.: Respiratory distress in newborn infants. Brit. med. Bull. 19, 45–48 (1963).

    Google Scholar 

  64. Usher, R.: The respiratory distress syndrome of prematurity. Pediatrics 24, 562–576 (1959).

    Google Scholar 

  65. — Management of metabolic changes in the respiratory distress syndrome of prematurity. Transactions of the Soc. for Pediatr. Research: 30th Annual Meeting, Swampscott, Mass., may 3–4, 1960. Amer. J. Dis. Child. 100, 485 (1960).

    Google Scholar 

  66. —: The metabolic changes in respiratory distress syndrome of prematurity seen as a failure of somatic compensations for asphyxia. In G. E. W. Wolstenholme, and M. O'Connor (Ed.): Ciba Foundation Symposium on somatic stability in the newly born. London: Churchill 1961.

    Google Scholar 

  67. —: Controlled series trial of intravenous glucose and bicarbonate therapy for respiratory distress syndrome of prematurity. Soc. f. Pediatr. Research, 31st Annual Meeting, Atlantic City, N. Y., May 4–5, 1961. Amer. J. Dis. Child. 102, 636 (1961).

    Google Scholar 

  68. —: Clinical investigation of the respiratory distress syndrome of prematurity. Interim report. N. Y. State J. Med. 61, 1677–1696 (1961).

    Google Scholar 

  69. —: Reduction of mortality from respiratory distress syndrome of prematurity with early administration of intravenous glucose and sodium bicarbonate. Pediatrics 32, 966 (1963).

    Google Scholar 

  70. van Slyke, D. D., and G. E. Cullen: Studies of acidosis. I. The bicarbonate concentration of the blood plasma; its significance, and its determination as a measure of acidosis. J. biol. Chem. 30, 289 (1917).

    Google Scholar 

  71. Vedra, B.: Acidosis and anaerobiosis in full term infants. Acta paediat. (Uppsala) 48, 60–69 (1959).

    Google Scholar 

  72. — and J. Ulrych: Anaerobiosis in normal and asphyxiated premature newborns. Acta. paediat. (Uppsala) 49, 129–134 (1960).

    Google Scholar 

  73. Villee, L. A.: The role of anaerobic metabolism in fetal and neonatal survival. 9th International Congr. of Paediatr., Montreal, Canada, July 1959. Acta paediat. (Uppsala) 49, Suppl. 122, 5–16 (1960).

    Google Scholar 

  74. Warley, M. A., and D. Gairdner: Respiratory distress syndrome of the newborn-principles in treatment. Arch. Dis. Childh. 37, 455–465 (1962).

    Google Scholar 

  75. Weber, E.: Grundriß der biologischen Statistik, 5. Aufl. Jena: Fischer 1964.

    Google Scholar 

  76. Weidtmann, V.: Einflüsse auf den Säurebasenhaushalt in den ersten Lebensstunden. Arch. Kinderheilk. 168, 35–46 (1963).

    Google Scholar 

  77. Weippl, G.: Die Beurteilung des Säure-Basen-Haushaltes bei Frühgeborenen. Pädiat. Prax. 4, 523–525 (1965).

    Google Scholar 

  78. Weisbrot, I. M., L. S. James, C. E. Prince, D. A. Holaday, and V. Apgar: Acid-base homeostasis of the newborn infant during the first 24 hours of life. J. Pediat. 52, 395–403 (1958).

    Google Scholar 

  79. Ylppö, A.: Neugeborenen-, Hunger- und Intoxikationsacidosis in ihren Beziehungen zueinander. Z. Kinderheilk. 14, 268–448 (1916).

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Additional information

Ausführliche Darstellung: R. Kellner, Inauguraldissertation, Rostock 1966.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kellner, R. Untersuchungen über die postnatale Regulation des Säure-Basen-Stoffwechsels bei gesunden Frühgeborenen. Z. Kinder-Heilk. 97, 299–314 (1966). https://doi.org/10.1007/BF00523280

Download citation

  • Received:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00523280

Navigation