The specific aims of this research are 1) to determine the pulmonary excretion rate of carbon monoxide (VECO) as an index of heme catabolism or total bilirubin formation (TBF) in premature or sick infants, 2) to study the relationship of VECO to carboxy-hemoglobin (COHb) and the factors governing this relationship and 3) to characterize the hormonal milieu at the time of birth in relation to postnatal TBF. Methodology includes determination of VECO using an open, flow-through hood collection system with modifications for studying subjects on ventilators and a gas chromatograph analyzer, utilizing a reduction gas detector with a CO resolution of (plus/minus) 1 part per billion, and other relevant measurements: COHb, serum vitamin E, in vitro hydrogen peroxide stress project incorporates and expertise of the pediatric subspecialties of neonatal-perinatal medicine, nutrition/metabolism, endocrinology and hematology as well as engineering and biochemistry. It utilizes the unique, noninvasive technique of trace gas analysis, which is well-suited for pediatric applications, especially studies involving infants. The importance of this research emanates from the specific aims which outline a multifaceted, highly integrated project, designed to address major gaps in our current knowledge regarding two very common problems in premature or sick infants related to postnatal heme catabolism: hyperbilirubinemia and anemia. Estimates of TBF in the first postnatal week will provide practical information about the magnitude of a major contributing factor to exaggerated neonatal jaundice in these subjects who are most at risk for injury related to bilirubin toxicity. Weekly estimates of TBF later in the postnatal period may reflect accurately red blood cell breakdown and thus can be used to assess antioxidant defense mechanisms in infants who are most at risk for hemolysis and anemia.

Agency
National Institute of Health (NIH)
Institute
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Type
Research Project (R01)
Project #
5R01HD014426-05
Application #
3312584
Study Section
Human Embryology and Development Subcommittee 2 (HED)
Project Start
1980-08-01
Project End
1986-03-31
Budget Start
1985-04-01
Budget End
1986-03-31
Support Year
5
Fiscal Year
1985
Total Cost
Indirect Cost
Name
Stanford University
Department
Type
Schools of Medicine
DUNS #
800771545
City
Stanford
State
CA
Country
United States
Zip Code
94305
Wong, R J; Vreman, H J; Schulz, S et al. (2011) In vitro inhibition of heme oxygenase isoenzymes by metalloporphyrins. J Perinatol 31 Suppl 1:S35-41
Seidman, Daniel S; Moise, Jonathan; Ergaz, Zivanit et al. (2003) A prospective randomized controlled study of phototherapy using blue and blue-green light-emitting devices, and conventional halogen-quartz phototherapy. J Perinatol 23:123-7
Meny, Robert G; Vreman, Hendrik J; Stevenson, David K et al. (2002) Failure to detect elevated levels of carboxyhemoglobin in infants dying from SIDS. J Forensic Sci 47:660-2
Vreman, H J; Wong, R J; Stevenson, D K (2001) Alternative metalloporphyrins for the treatment of neonatal jaundice. J Perinatol 21 Suppl 1:S108-13; discussion S125-7
Dennery, P A; Seidman, D S; Stevenson, D K (2001) Neonatal hyperbilirubinemia. N Engl J Med 344:581-90
Stevenson, D K; Vreman, H J; Wong, R J et al. (2001) Carbon monoxide and bilirubin production in neonates. Semin Perinatol 25:85-93
Seidman, D S; Moise, J; Ergaz, Z et al. (2000) A new blue light-emitting phototherapy device: a prospective randomized controlled study. J Pediatr 136:771-4
Vreman, H J; Wong, R J; Kim, E C et al. (2000) Haem oxygenase activity in human umbilical cord and rat vascular tissues. Placenta 21:337-44
Vreman, H J; Haenen, G R; Stevenson, D K et al. (2000) Reduction of the NO-mediated response in the rat aorta by metalloporphyrins. Can J Physiol Pharmacol 78:457-61
Hayde, M; Pollak, A; Bernaschek, G et al. (2000) Association of fetal and maternal carboxyhemoglobin levels in normal and Rh-alloimmune pregnancies. Early Hum Dev 58:205-12

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