Early life events, sex, and arterial blood pressure in critically ill infants

Authors: Chessex, P., Khashu, M., Harrison, A., Hosking, M., Sargent, M. and Lavoie, J.C.

Journal: Pediatric Critical Care Medicine

Volume: 11

Issue: 1

Pages: 75-81

ISSN: 1529-7535

DOI: 10.1097/PCC.0b013e3181b010f8

Abstract:

Objective: To determine whether photo-protecting total parenteral nutrition in preterm infants influences arterial blood pressure differently according to gender. Blood pressure is influenced by complex mechanisms of vasomodulation. Oxidants are mediators and effectors in such reactions. Shielding total parenteral nutrition from light contributes to decrease the generation of peroxides. Girls may be better protected against an oxidant load than boys. We questioned whether shielding total parenteral nutrition may have cardiovascular effects that are influenced by gender. Design: A post hoc subgroup analysis of the effect of shielding parenteral nutrition from light. Setting: Neonatal intensive care unit. Subjects: Preterm infants <1000 g with indwelling arterial catheters who received light exposed (n = 20) or light protected (n = 20) parenteral nutrition. Interventions: Invasive monitoring, total parenteral nutrition. Measurements and Main Results: Arterial blood pressure was recorded hourly and compared between light exposed and light protected over the first week of life; timed average maximum velocity (m/s) was measured in the superior mesenteric artery by Doppler; presence of ductus arteriosus was documented by cardiac ultrasound. Data were analyzed by analysis of variance. No differences were noted between light exposed and light protected in clinical determinants that may influence blood pressure. There was an interaction (p < .01) between gender and total parenteral nutrition on blood pressure. In girls (n = 17), systolic and diastolic blood pressures were higher (p < .01) and heart rate lower (p < .01) during light exposed. There was no effect on BP observed in boys (n = 23). The linear correlation between timed average maximum velocity and systolic blood pressure was positive (p < .05). There was no echocardographic difference in hemodynamic variables between boys (n = 21) and girls (n = 9) who had a patent ductus. Conclusion: Failure to shield total parenteral nutrition from light results in higher blood pressure in a selected population of critically ill female infants. This information adds to our understanding of the multiple determinants involved in optimizing arterial blood pressure in a critical care environment. © 2010 by the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies.

Source: Scopus

Early life events, sex, and arterial blood pressure in critically ill infants.

Authors: Chessex, P., Khashu, M., Harrison, A., Hosking, M., Sargent, M. and Lavoie, J.-C.

Journal: Pediatr Crit Care Med

Volume: 11

Issue: 1

Pages: 75-81

ISSN: 1529-7535

DOI: 10.1097/PCC.0b013e3181b010f8

Abstract:

OBJECTIVE: To determine whether photo-protecting total parenteral nutrition in preterm infants influences arterial blood pressure differently according to gender. Blood pressure is influenced by complex mechanisms of vasomodulation. Oxidants are mediators and effectors in such reactions. Shielding total parenteral nutrition from light contributes to decrease the generation of peroxides. Girls may be better protected against an oxidant load than boys. We questioned whether shielding total parenteral nutrition may have cardiovascular effects that are influenced by gender. DESIGN: A post hoc subgroup analysis of the effect of shielding parenteral nutrition from light. SETTING: Neonatal intensive care unit. SUBJECTS: Preterm infants <1000 g with indwelling arterial catheters who received light exposed (n = 20) or light protected (n = 20) parenteral nutrition. INTERVENTIONS: Invasive monitoring, total parenteral nutrition. MEASUREMENTS AND MAIN RESULTS: Arterial blood pressure was recorded hourly and compared between light exposed and light protected over the first week of life; timed average maximum velocity (m/s) was measured in the superior mesenteric artery by Doppler; presence of ductus arteriosus was documented by cardiac ultrasound. Data were analyzed by analysis of variance. No differences were noted between light exposed and light protected in clinical determinants that may influence blood pressure. There was an interaction (p < .01) between gender and total parenteral nutrition on blood pressure. In girls (n = 17), systolic and diastolic blood pressures were higher (p < .01) and heart rate lower (p < .01) during light exposed. There was no effect on BP observed in boys (n = 23). The linear correlation between timed average maximum velocity and systolic blood pressure was positive (p < .05). There was no echocardographic difference in hemodynamic variables between boys (n = 21) and girls (n = 9) who had a patent ductus. CONCLUSION: Failure to shield total parenteral nutrition from light results in higher blood pressure in a selected population of critically ill female infants. This information adds to our understanding of the multiple determinants involved in optimizing arterial blood pressure in a critical care environment.

Source: PubMed

Preferred by: Minesh Khashu

Early life events, sex, and arterial blood pressure in critically ill infants

Authors: Chessex, P., Khashu, M., Harrison, A., Hosking, M., Sargent, M. and Lavoie, J.-C.

Journal: PEDIATRIC CRITICAL CARE MEDICINE

Volume: 11

Issue: 1

Pages: 75-81

eISSN: 1947-3893

ISSN: 1529-7535

DOI: 10.1097/PCC.0b013e3181b010f8

Source: Web of Science (Lite)

Early life events, sex, and arterial blood pressure in critically ill infants.

Authors: Chessex, P., Khashu, M., Harrison, A., Hosking, M., Sargent, M. and Lavoie, J.-C.

Journal: Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies

Volume: 11

Issue: 1

Pages: 75-81

ISSN: 1529-7535

DOI: 10.1097/pcc.0b013e3181b010f8

Abstract:

Objective

To determine whether photo-protecting total parenteral nutrition in preterm infants influences arterial blood pressure differently according to gender. Blood pressure is influenced by complex mechanisms of vasomodulation. Oxidants are mediators and effectors in such reactions. Shielding total parenteral nutrition from light contributes to decrease the generation of peroxides. Girls may be better protected against an oxidant load than boys. We questioned whether shielding total parenteral nutrition may have cardiovascular effects that are influenced by gender.

Design

A post hoc subgroup analysis of the effect of shielding parenteral nutrition from light.

Setting

Neonatal intensive care unit.

Subjects

Preterm infants <1000 g with indwelling arterial catheters who received light exposed (n = 20) or light protected (n = 20) parenteral nutrition.

Interventions

Invasive monitoring, total parenteral nutrition.

Measurements and main results

Arterial blood pressure was recorded hourly and compared between light exposed and light protected over the first week of life; timed average maximum velocity (m/s) was measured in the superior mesenteric artery by Doppler; presence of ductus arteriosus was documented by cardiac ultrasound. Data were analyzed by analysis of variance. No differences were noted between light exposed and light protected in clinical determinants that may influence blood pressure. There was an interaction (p < .01) between gender and total parenteral nutrition on blood pressure. In girls (n = 17), systolic and diastolic blood pressures were higher (p < .01) and heart rate lower (p < .01) during light exposed. There was no effect on BP observed in boys (n = 23). The linear correlation between timed average maximum velocity and systolic blood pressure was positive (p < .05). There was no echocardographic difference in hemodynamic variables between boys (n = 21) and girls (n = 9) who had a patent ductus.

Conclusion

Failure to shield total parenteral nutrition from light results in higher blood pressure in a selected population of critically ill female infants. This information adds to our understanding of the multiple determinants involved in optimizing arterial blood pressure in a critical care environment.

Source: Europe PubMed Central