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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    European journal of pediatrics 148 (1988), S. 253-256 
    ISSN: 1432-1076
    Keywords: Noradrenaline ; Adrenaline ; Hypoglycaemia ; Infants
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The response of the sympathoadrenal system to hypoglycaemia of different etiology was studied in seven infants, aged 10–189 days. Five infants had hyperinsulinism secondary to nesidioblastosis or to a β-cell adenoma of the pancreas, one infant had neonatal sepsis due to staphylococcal infection and one infant congenital growth hormone (HGH) and adrenocorticotropic hormone (ACTH) deficiency. In babies with hyperinsulinism, plasma noradrenaline increased from 0.29±0.03 to 0.61±0.09 ng/ml (P〈0.01), whereas adrenaline increased only in three, but did not change in two babies. Increases in heart rate and blood pressure paralleled these changes. In hypoglycaemia due to congenital sepsis, noradrenaline increased from 0.39 to 1.64 ng/ml and adrenaline from 0.05 to 0.86 ng/ml. This was associated with marked haemodynamic changes. In congenital HGH and ACTH deficiency, the low basal plasma levels of noradrenaline (0.12 ng/ml) and adrenaline (0.01 ng/ml) remained unchanged in response to hypoglycaemia. Heart rate and blood pressure were unaffected. The sympathoadrenal system was activated by hypoglycaemia in all infants except in congenital HGH and ACTH deficiency. In contrast to adults, noradrenaline was the preferentially released catecholamine, suggesting an involvement of noradrenaline in glucose counter regulation in infancy.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-1041
    Keywords: hypotension ; nitroprusside ; bunitrolol ; plasma catecholamines ; plasma renin activity ; haemodynamics
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Summary The effects of β-blockade on certain physiological and haemodynamic responses to sodium nitroprusside-induced hypotension have been studied in 5 patients, aged 18–54 years, undergoing inner ear surgery. Samples of blood were collected unter premedication, following induction of anaesthesia, during neuroleptanalgesia, during a sodium nitroprusside infusion adjusted to produce a 40% fall in blood pressure, during superimposed β-blockade with bunitrolol and under stable haemodynamic conditions after discontinuation of sodium nitroprusside. The sodium nitroprusside-induced reduction in blood pressure led to a massive increase in plasma noradrenaline and adrenaline and in plasma renin activity. β-blockade with bunitrolol did not affect the increased catecholamine concentrations, the increase in plasma renin activity was significantly reduced, the increase in heart rate was reversed, and total peripheral resistance and diastolic blood pressure were further reduced. These changes can be attributed to the intrinsic β-sympathomimetic activity of bunitrolol in addition to its β-blocking effect. Since no adverse effect was observed in this study, combined therapy with sodium notroprusside and β-receptor blockade should be employed if the effects of increased sympathetic tone are considered to be undesirable.
    Type of Medium: Electronic Resource
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