Brief clinical and laboratory observations

Voilime 93 Number 6

need for transfusion. Low levels of Sao. indicate that changes in oxygen or ventilation therapy are necessary and we use the oximeter as a guide to effect these changes. After an adequate improvement in Sao., we check blood gas tensions and pH. We adjust inspired oxygen and ventilatory support to keep Sao. at approximately 90%, and when above 96% we measure Pao•. We have shown that if Sao. is 96% or less, the chance of the Pao. exceeding 100 torr is less than 5%." In the majority of infants who are sick enough to need an arterial catheter, the Sao. fluctuates between 85 and 95% when they are in a stable condition. We are grateful to the staff of the Intensive Care Nursery of H.C. Moffitt Hospital and the staff of the Clinical Physiology Services Laboratory of the Cardiovascular Research Institute for thier help in carrying out this study.

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2. Kitterman lA, Phibbs RH, and Tooley WH: Aortic blood pressure in normal newborn infants during the first 12hours of life, Pediatrics 44:959, 1969. 3. Polanyi ML, and Hihir RM: In vivo oximeter with fast dynamic response, Rev Sci Instrum 33:1050, 1962. 4. Ensen Y, Briscoe WA, Polanyi ML, and Cournand A: In vivo studies with an intravascular and intracardiac reflection oximeter, J Appl Physiol 17:552, 1962. 5. Symansky MR, and Fox HA: Umbilical vessel catheterization: Indications, management, and evaluation of the technique, J PEDIATR 80:820, 1972. 6. Cochran WD, Davis HT, and Smith CA: Advantages and complications of umbilical artery catheterization in the newborn, Pediatrics 42:769, 1968. 7. Clark 1M, and Jung AL: Umbilical artery catheterization by a cutdown procedure, Pediatrics 59:1036, 1977. 8. Wilkinson AR, Phibbs RH, and Gregory GA: In vivo oxygen dissociation curves in transfused and untransfused newborn infants, Clin Res 26:202A, 1978 (abstr),

REFERENCES l.

Kitterman JA, Phibbs RH, and Tooley WH: Catheterization of umbilical vessels in newborn infants, Pediatr Clin North Am 17:895, 1970.

Neonatal lead intoxication in a prenatally exposed infant Nalini Singh, M.B., B.S., Carol M. Donovan, M.A., R.P.T., and James B. Hanshaw, M.D., Worcester, Mass.

LEAD POISONING is a significant problem among infants and children in contact with lead-based paint. The transfer of lead across the human placenta and its potential threat to the conceptus have been recognized since the early part of this century. The effects oflead are dose related; the mother in this report had far less plumbism than those reports of many years ago, which were clearly' associated with severe fetal damage. It is known that lead can be transferred from the placenta to the fetus at different stages of gestation, I. , and lead has been found in the cord blood of newborn infants delivered in Boston- and New York City' in concentrations ranging from 10 to 30 ug/dl. The following report represents the first example of a liveborn infant with biochemical evidence of lead intoxication due to prenatal exposure to lead.

CASE REPORT A 3,200 gm white girl was born after 40 weeks gestation to a 20-year-old" mother who, with her husband, had removed paint

From the Department of Pediatrics, University of Massachusetts Medical School.

0022-3476/781121019+03$00.3010

Neonatal lead intoxication in a prenatally exposed infant.

Brief clinical and laboratory observations Voilime 93 Number 6 need for transfusion. Low levels of Sao. indicate that changes in oxygen or ventilati...
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