Abstract
The routine evaluation of stress and efficiency of its prevention remain difficult in preterm infants. A study was prospectively done to assess the best clinical indexes of acute stress and the effect of F treatment in 7 preterm infants, 32-35 weeks gestational age. The infants, 24-48 h old, were mechanically ventilated for respiratory distress syndrome (RDS). Assessment of behavioral state, heart rate (HR), blood pressure (BP), transcutaneous PO2 and SaO2 was done throughout the study. The arterio-alveolar O2 ratio (a/AO2) was calculated as an index of RDS severity. Routine endotracheal suctionning was considered as an acute stress. Measurements of BE plasma levels were done before and after the suction as biological evidences of stress. The same procedure was performed 2 h later, after IV infusion of 3 μg/kg of F, the infants being their own control.
Results: 1) There was a significant linear relationship between βE and the following parameters: HR (r= 0.397 p=0.041), PO2 (r= - 0.413 p=0.032) and a/AO2 (r= - 0.469 p=0.014), but not with behavior, BP nor SaO2.
2) Effect of F on the acute stress [δ = post- minus pre- suction values]:
Conclusions: 1) The clinical indexes related to βE were HR.PO2 and a/AO2. 2) F blunted the alterations of PO2, SaO2 and a/AO2 related to stress.
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Hamon, I., Hascoët, JM., Thorin, E. et al. RELATION BETWEEN BETA ENDORPHINS (βE) AND CLINICAL INDEXES OF STRESS IN SICK PRETERM INFANTS: EFFECT OF FENTANYL (F). Pediatr Res 32, 633 (1992). https://doi.org/10.1203/00006450-199211000-00170
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DOI: https://doi.org/10.1203/00006450-199211000-00170