Cortisol and 17-a-hydroxy-progesterone levels in infants with refractory hypotension born at 30 weeks of gestation or less

Refractory hypotension is frequent in very low-birth weight infants, whose hypothalamic-pituitary-adrenal axis has been suggested to be immature. The objective of the present study was to evaluate basal cortisol and 17-a-OH-progesterone in the first 36 h of life in preterm infants with and without refractory hypotension (mean arterial blood pressure below the lower limit for gestational age throughout the study despite aggressive volume expansion and use of vasopressors). Thirty-five infants with £30 weeks of gestation and a birth weight £1250 g, with no postnatal use of corticosteroid or death in the first 48 h were studied. Mean arterial pressure was measured every 4 h during the first 48 h. Cortisol and 17-a-OH-progesterone were determined at 12 and 36 h and patients were divided into refractory hypotensive (N = 15) and control (N = 20) groups. The groups were not different regarding type of delivery, use of prenatal corticosteroid, requirement of mechanical ventilation, use of vasopressor drugs, morphine, fentanyl, prophylactic indomethacin, and mean sample timing. Although refractory hypotensive newborns were more immature, were smaller, suffered more deaths after 48 h of life and had a higher SNAPPE-2 score, their cortisol and 17-a-OH-progesterone levels were not different from controls at 12 h and at 36 h. The increase of cortisol in newborns with refractory hypotension 36 h after birth was significantly higher than in controls. Despite the fact that refractory hypotensive very low-birth weight neonates were submitted to a very stressful condition, their cortisol and 17-a-OH-progesterone levels were similar to controls.

Le Petit journal. Supplément du dimanche

1914/12/06 (Numéro 1250).

L'Écho de Paris

1887/08/20 (Numéro 1250).

Papias, Vocabularium, pars secunda (N-Z).

Ce ms. a appartenu à la bibliothèque du chapitre de Notre-Dame de Paris. Au contreplat sup. figure l'ex-libris "A la bibliotheque de l'Eglise de Paris", précédé de la cote M2 (XVIIe s.). Notre-Dame.

[Recueil].

Pseudo-Augustinus, De spiritu et anima (1-8). - Ricardus de Sancto Victore, De gradibus caritatis (8v-17v). - Hugo de Sancto Caro, Speculum ecclesiae (17v-22). - De canone missae (22-34v). - Instructio confessorum (34v-36). - Sermones [Nicolaus de Byard et alii] (37-193v). - Adelardus Bathoniensis, Quaestiones naturales perdifficiles (195-210v). - Alanus de Insulis, Quaestiones naturales (210v-227). - Marbodus Redonensis, Liber lapidum (227-231v). - Zacharias de Salerno, Liber de passionibus oculorum (231v-238v). - Versus de signis tempestatum (238v-239v).

Biblia sacra. Biblia sacra.

Jacobins de la rue Saint-Jacques.

Biblia sacra. Biblia sacra.

Jacobins de la rue Saint-Jacques.

Vetus testamentum, pars (Genesis-Job).

Ce ms. a été légué au chapitre de Notre-Dame par Pierre du Jardin, prêtre du diocèse de Limoges et chapelain de Notre-Dame de Paris, mort en 1431, comme l'indique la note au f. 251v: "Venerabilis et discretus vir deffunctus dominus Petrus de Orto, alias dictus Mallerat, presbiter Lemovicensis diocesis, quondam cappellanus hujus venerabilis eccelesie Parisiensis, qui obiit anno M° CCCC° XXXI° die XXIII° mensis aprilis, legavit per suum testamentum supra dicte ecclesie hunc presentem librum..." (XVe s.). Au f. 1 figure l'ex-libris "A la bibliotheque de l'Eglise de Paris" (XVIIe s.). Notre-Dame.

Justinianus imperator, Codex, libri I-IX, cum glossis.

Au f. 1v figurent un ex-libris effacé et une mention de possesseur (?): "Girardo di Piotte di Torunzzo", ainsi que la mention "A la bibliotheque de l'Eglise de Paris" précédée de la cote F9 (XVIIe s.). Notre-Dame.

Justinianus imperator, Codex, libri I-IX, cum glossa ordinaria Accursii.

Le ms. a reçu des additions à la glose ordinaire, de différentes mains du XIVe s., dont certaines signées: "Jo. Faber" (passim, entre les ff. 157v et 185), "Ja." (81v), "Ja. de Ravenna et chy." (98). Les ff. 98, 163-165 et 185, montés sur onglets, ont été rajoutés pour accueillir des additions à la glose, d'une main du XIVe s., la même qui a inséré les additions signées "Jo. Faber".; le f. 98 est détaché.

Livres sapientiaux et Job, avec glose.

Augustins.

Psalterium glossatum (1-100v).

Abbaye Saint-Maur-des-Fossés ; cf. B. de Montfaucon, Bibliotheca bibliothecarum, II, 1739, p.1141-1143 : "7. 1031. Liber Psalmorum & Vitae Sanctorum, & sermones multi". Ex-libris : F 1 : signature: « Savan ». Saint-Maur-des-Fossés (d'après le sanctoral).

Sermones diversi.

En bas du f. 1, note du XVe s.: "Ad usum fratris Ludovici [...] [conven]tus Compendiensis ordinis fratrum predicatorum", de la même main que celle qui a écrit le titre du ms. en tête. Il s'agit probablement d'un moine du couvent dominicain installé à Compiègne vers 1254. Compiègne.