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健康及复苏后的新生儿出生后即刻的体温调节

Temperature regulation in healthy and resuscitated newborns immediately after birth.

作者信息

Schubring C

出版信息

J Perinat Med. 1986;14(1):27-33. doi: 10.1515/jpme.1986.14.1.27.

Abstract

Oxygen consumption (VO2) is a sensitive and reliable indicator of any disturbances of thermoregulatory adaptation in the newborn. This study has been carried out in a attempt to find out, if there is any difference between the thermoregulatory processes of healthy and resuscitated neonates. To this end, both VO2 and rectal temperature (RT) were continuously measured in 31 healthy and 13 resuscitated neonates respectively, within the first 140 postnatal minutes and during 30 minutes from the second until the fifth day of their lives. In the healthy neonates, the VO2 used to decrease over the study period. The high initial VO2 observed postnatally is due to mechanisms of thermoregulation beginning immediately after delivery as soon as the newborn child is exposed to chilly environmental temperatures. The brown adipose tissue (BAT) is supposed to be the essential site of non-shivering thermogenesis (NST). The thermogenetic function of this tissue may be shown by local measuring of temperature. In the resuscitated neonates, VO2 was lower than in the healthy children. Hypoxia results in an ineffective capillary blood supply of the BAT owing to a redistribution of circulating blood volume, thus leading to a disturbance of thermoregulation. Since the activity of the BAT is dependent on oxygen supply hypoxia might be regarded as the limiting factor. In the presence of an isothermal environment, the RT measured in the healthy children differed from those determined in the resuscitated neonates. This clearly shows that thermoregulatory processes may be impaired by a difficult birth.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

氧耗量(VO2)是新生儿体温调节适应任何紊乱的敏感且可靠指标。本研究旨在探究健康新生儿和复苏后新生儿的体温调节过程是否存在差异。为此,分别对31名健康新生儿和13名复苏后新生儿在出生后前140分钟以及出生后第二天至第五天的30分钟内持续测量VO2和直肠温度(RT)。在健康新生儿中,VO2在研究期间呈下降趋势。出生后观察到的高初始VO2是由于新生儿一旦暴露于寒冷环境温度,分娩后立即启动的体温调节机制所致。棕色脂肪组织(BAT)被认为是非寒战产热(NST)的关键部位。该组织的产热功能可通过局部温度测量来显示。在复苏后新生儿中,VO2低于健康儿童。缺氧会导致循环血量重新分布,使BAT的毛细血管血液供应不足,进而导致体温调节紊乱。由于BAT的活性依赖于氧气供应,缺氧可能被视为限制因素。在等温环境下,健康儿童测量的RT与复苏后新生儿测定的RT不同。这清楚地表明,难产可能会损害体温调节过程。(摘要截选至250字)

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