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dopamine and shock in neonates

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https://www.readbyqxmd.com/read/25990594/management-of-shock-in-neonates
#1
B Vishnu Bhat, Nishad Plakkal
Shock is characterized by inadequate oxygen delivery to the tissues, and is more frequent in very low birth weight infants, especially in the first few days of life. Shock is an independent predictor of mortality, and the survivors are at a higher risk of neurologic impairment. Understanding the pathophysiology helps to recognize and classify shock in the early compensated phase and initiate appropriate treatment. Hypovolemia is rarely the primary cause of shock in neonates. Myocardial dysfunction is especially common in extremely preterm infants, and in term infants with perinatal asphyxia...
October 2015: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/25565195/managing-neonatal-severe-sepsis-in-germany-a-preliminary-survey-of-current-practices
#2
L Koch, A Bosk, M Sasse, P Ruef, J Poeschl
BACKGROUND: In 2002 and 2007, the American College of Critical Care Medicine (ACCCM) provided clinical guidelines for hemodynamic support of pediatric and neonatal patients in septic shock. In 2008 and 2013, the Surviving Sepsis Campaign (SSC) Guidelines Committee offered up-to-date clinical guidelines for the management of severe sepsis and septic shock in adults and in pediatric patients. The aim of this study was to assess the standard of care of neonates with severe sepsis and septic shock in German neonatal intensive care units (NICUs) with regard to variability in management and guideline conformity...
January 2015: Klinische Pädiatrie
https://www.readbyqxmd.com/read/24877491/a-neonate-with-critical-congenital-heart-disease
#3
Jarrett Linder, Emily Dawson, Paula Williams
Critical congenital heart disease (CCHD) is defined as a ductal-dependent congenital heart defect requiring surgical or percutaneous intervention via cardiac catheterization before 1 year of age. Most cases of CCHD can be diagnosed with prenatal ultrasound or fetal echocardiogram. If not prenatally diagnosed, CCHD can be stable in the newborn nursery due to persistent ductal patency, and the patient may only be diagnosed after ductal closure and development of cardiac symptoms at home. In this case, a 6-day-old female presented to the emergency department (ED) floppy with agonal respirations, poor capillary refill, and absent femoral pulses...
May 2014: Pediatric Annals
https://www.readbyqxmd.com/read/24717905/hemodynamic-changes-in-preterm-neonates-with-septic-shock-a-prospective-observational-study
#4
Shiv Sajan Saini, Praveen Kumar, Rohit Manoj Kumar
OBJECTIVE: We evaluated hemodynamic changes in preterm neonates with septic shock using functional echocardiography and studied the effects of vasoactive drugs on hemodynamic variables. DESIGN: Prospective observational study. SETTING: Level III neonatal ICU. SUBJECTS AND PATIENTS: We enrolled 52 preterm neonates with septic shock (shock group) and an equal number of gestation and postnatal age-matched healthy neonates (control group)...
June 2014: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/23344679/a-comparison-of-combination-dopamine-and-epinephrine-treatment-with-high-dose-dopamine-alone-in-asphyxiated-newborn-piglets-after-resuscitation
#5
COMPARATIVE STUDY
Namdar Manouchehri, David L Bigam, Thomas Churchill, David Rayner, Chloe Joynt, Po-Yin Cheung
BACKGROUND: When asphyxiated neonates require additional cardiovascular support to moderate doses of dopamine infusion, controversy exists on the differential hemodynamic effects of two approaches (adding a second inotrope vs. increasing dopamine dosage). We hypothesized that high-dose dopamine (HD) would be detrimental to systemic and regional perfusion as compared with dopamine and epinephrine (D + E) combination therapy using a swine model of neonatal hypoxia-reoxygenation (H-R). METHODS: Twenty-seven piglets (1-4 d, 1...
April 2013: Pediatric Research
https://www.readbyqxmd.com/read/22341548/neonatal-blood-pressure-support-the-use-of-inotropes-lusitropes-and-other-vasopressor-agents
#6
REVIEW
Shahab Noori, Istvan Seri
A solid understanding of the mechanisms of action of cardiovascular medications used in clinical practice along with efforts to develop comprehensive hemodynamic monitoring systems to improve the ability to accurately identify the underlying pathophysiology of cardiovascular compromise are essential in the management of neonates with shock. This article reviews the mechanisms of action of the most frequently used cardiovascular medications in neonates. Because of paucity of data from controlled clinical trials, evidence-based recommendations for the clinical use of these medications could not be made...
March 2012: Clinics in Perinatology
https://www.readbyqxmd.com/read/21048262/intravenous-adrenaline-for-shock-in-neonates
#7
Ruchi Rai, D K Singh
Dopamine and dobutamine have been widely used to treat shock with variable success in newborns. In this retrospective data analysis, we report on the use of adrenaline in 20 neonates with birth asphyxia and shock that was refractory to dopamine and dobutamine. We concluded that adrenaline is a safe and effective drug that can be used as an add-on therapy to dopamine and/or dobutamine in newborns with shock secondary to birth asphyxia.
September 2010: Indian Pediatrics
https://www.readbyqxmd.com/read/20308763/intravenous-adrenaline-for-shock-in-neonates
#8
Ruchi Rai, D K Singh
Dopamine and dobutamine have been widely used to treat shock with variable success in newborns. In this retrospective data analysis, we report on the use of adrenaline in 20 neonates with birth asphyxia and shock that was refractory to dopamine and dobutamine. We concluded that adrenaline is a safe and effective drug that can be used as an add-on therapy to dopamine and/or dobutamine in newborns with shock secondary to birth asphyxia.
January 15, 2010: Indian Pediatrics
https://www.readbyqxmd.com/read/20094123/-paediatric-intensive-care
#9
Ulf Mostad, Sigurd Fasting
BACKGROUND: Child physiology and disease is not the same as in adults, which implies different challenges within intensive care. The aim of this review article is to shed light on special diagnostic and therapeutic problems in paediatric intensive care. MATERIAL AND METHODS: The review is based on literature identified through a non-systematic search in PubMed, and on the authors' own clinical experience. RESULTS: Common causes for admitting children to intensive care units are head injuries; septic shock and respiratory failure...
January 14, 2010: Tidsskrift for Den Norske Lægeforening: Tidsskrift for Praktisk Medicin, Ny Række
https://www.readbyqxmd.com/read/19696569/hypotension-and-shock-in-the-preterm-neonate
#10
REVIEW
Chris Schmaltz
While the methods of establishing and maintaining organ perfusion differ from one clinician to the next, the underlying physiological rationale remains constant. The gestalt for correcting circulatory compromise is generally performed in a stepwise manner; first ensuring that the vasculature is filled, then administering medications to tighten the vasculature, and lastly, compensating for an immature vasculature. This stepwise approach is reflected in the pharmacological interventions of providing fluid boluses (filling the pump), giving catecholamines (tightening the pump), and starting hydrocortisone (compensating for an immature pump)...
August 2009: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
https://www.readbyqxmd.com/read/17972551/neonates-with-left-sided-obstructive-heart-disease-clinical-manifestation-and-management-at-primary-care-hospitals
#11
L Kovacikova, K Dakkak, P Skrak, M Zahorec, M Holan
BACKGROUND: In neonates, left-sided obstructive heart defects are critical diseases requiring early recognition, initial stabilization, and transfer to Cardiac Center. OBJECTIVES: To assess management of these neonates in primary care hospitals. METHODS: Retrospective analysis of medical records of neonates admitted to Cardiac Intensive Care Unit in whom diagnosis of left-sided obstructive heart defect was established. RESULTS: During 8-year period records of 117 patients were evaluated...
2007: Bratislavské Lekárske Listy
https://www.readbyqxmd.com/read/17577139/systemic-and-regional-hemodynamic-effects-of-high-dose-epinephrine-infusion-in-hypoxic-piglets-resuscitated-with-100-oxygen
#12
Po-Yin Cheung, Sameh Abozaid, Zakariya Al-Salam, Scott Johnson, Yingqian Li, David Bigam
Shock and poor regional perfusion are common in asphyxiated neonates. We compared the systemic and regional hemodynamic effects of high-dose epinephrine (E) with those of dopamine combined with low-dose epinephrine (DE) infusions in a neonatal model of hypoxia-reoxygenation. Neonatal piglets (1-3 days, 1.5-2.5 kg) were acutely instrumented to continuously monitor systemic arterial pressure (SAP), pulmonary artery pressure, cardiac index (CI), and blood flows at the left common carotid, superior mesenteric, and renal arteries...
October 2007: Shock
https://www.readbyqxmd.com/read/16836022/-cardiogenic-shock-revealing-heart-disease-in-infancy-and-childhood-a-lebanese-multicentric-study
#13
MULTICENTER STUDY
Ghassan Chéhab, Zakhia Saliba, Philippe Chédid, Bernard Gerbaka, Chebl Mourani
OBJECTIVES: Diagnosis, initial workup and immediate prognosis in congenital or acquired heart diseases revealed by cardiogenic shock (CS) in a Lebanese paediatric multicentric study. MATERIAL AND METHODS: During a six-year period (1st January 1999 to 31 December 2004), 56 paediatric patients aged between 0 and 7 years have been admitted to the emergency departments or neonatal and intensive care units in ten different Lebanese hospitals, for high degree of CS suspicion with underlying cardiac disease...
October 2005: Le Journal Médical Libanais. the Lebanese Medical Journal
https://www.readbyqxmd.com/read/16113526/mild-intermittent-hypoxia-does-not-induce-stress-responses-in-the-neonatal-rat-brain
#14
Valerie Boss, Augusto Sola, Tong-Chun Wen, Michael J Decker
We previously demonstrated that intermittent hypoxia evokes persistent changes in extracellular striatal dopamine, locomotor activity and executive function, using a rodent model emulating apnea of prematurity in which rat pups are exposed to 20-second bursts of hypoxic gas mix containing 10% oxygen (60 events/h; 6 h/day) from postnatal days 7 to 11. To determine whether subtle repetitive hypoxic insults also induce expression of stress-related genes, we employed real-time RT-PCR to assay gene transcription in neonatal rats subjected to the same paradigm...
2005: Biology of the Neonate
https://www.readbyqxmd.com/read/15882935/diagnosis-and-treatment-of-neonatal-hypotension-outside-the-transitional-period
#15
REVIEW
Istvan Seri, Shahab Noori
The etiology and pathophysiology of the circulatory compromise are among the primary determinants of the clinical presentation of patients with neonatal shock. Therefore, in the absence of direct assessment of cardiac output and organ blood flow, the characteristic clinical presentation itself may guide the initial management of the circulatory compromise. This chapter discusses different pathophysiology-driven management approaches to a number of characteristic clinical presentations of neonatal shock. The clinical presentations discussed in detail are the hypotensive very low birth weight neonate with a hemodynamically significant patent ductus arteriosus, and the preterm or term neonate with perinatal depression, pressor/inotrope resistance and relative adrenal insufficiency, and with specific systemic inflammatory response syndrome...
May 2005: Early Human Development
https://www.readbyqxmd.com/read/15364852/prevention-of-early-sudden-circulatory-collapse-after-the-norwood-operation
#16
REVIEW
Nilto C De Oliveira, David A Ashburn, Faizah Khalid, Harold M Burkhart, Ian T Adatia, Helen M Holtby, William G Williams, Glen S Van Arsdell
BACKGROUND: After modifications in our perioperative management protocol, we have observed a decrease in sudden circulatory collapse after the Norwood operation. The current study examines early outcomes after the Norwood operation in our unit in an attempt to identify variables that may have altered the risk of unexpected circulatory collapse. METHODS AND RESULTS: We studied 105 consecutive neonates who underwent a Norwood operation in our institution. Our treatment protocol has changed in the past 3 years to include the use of alpha-blockade with phenoxybenzamine (POB) for systemic afterload reduction and selective cerebral perfusion...
September 14, 2004: Circulation
https://www.readbyqxmd.com/read/14987339/terlipressin-as-rescue-therapy-for-intractable-hypotension-during-neonatal-septic-shock
#17
Ilan Matok, Leah Leibovitch, Amir Vardi, Miriam Adam, Marina Rubinshtein, Zohar Barzilay, Gideon Paret
OBJECTIVE: To report the successful use of terlipressin in an 8-day-old infant for treatment of intractable hypotension caused by septic shock. DESIGN: Descriptive case report. SETTING: An 18-bed pediatric intensive care unit at a tertiary care children's hospital. PATIENT: An 8-day-old child with intractable hypotension due to septic shock after heart surgery. INTERVENTIONS: General supportive intensive care including mechanical ventilatory support, volume replacement, and inotropic support with dopamine 20 microg...
March 2004: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/14524566/venovenous-extracorporeal-membrane-oxygenation-for-respiratory-failure-in-inotrope-dependent-neonates
#18
Neil Roberts, Claire Westrope, Suneel K Pooboni, Hussain Mulla, Giles J Peek, Andrew W Sosnowski, Richard K Firmin
It is often stated that venovenous extracorporeal membrane oxygenation (VV ECMO) should not be used in inotrope dependent patients. It is our practice to use VV ECMO in most patients with respiratory failure even though many of these patients are receiving significant doses of inotropes. Our objective was to review the mode of ECMO in relation to precannulation doses of inotropes administered to neonates treated with ECMO for respiratory failure. Forty-three consecutive case notes were reviewed. Data were collected for basic demographic and ECMO parameters...
September 2003: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/14523168/early-reversal-of-pediatric-neonatal-septic-shock-by-community-physicians-is-associated-with-improved-outcome
#19
REVIEW
Yong Y Han, Joseph A Carcillo, Michelle A Dragotta, Debra M Bills, R Scott Watson, Mark E Westerman, Richard A Orr
OBJECTIVE: Experimental and clinical studies of septic shock support the concept that early resuscitation with fluid and inotropic therapies improves survival in a time-dependent manner. The new American College of Critical Care Medicine-Pediatric Advanced Life Support (ACCM-PALS) Guidelines for hemodynamic support of newborns and children in septic shock recommend this therapeutic approach. The objective of this study was to determine whether early septic shock reversal and use of resuscitation practice consistent with the new ACCM-PALS Guidelines by community physicians is associated with improved outcome...
October 2003: Pediatrics
https://www.readbyqxmd.com/read/11937726/endotoxemia-and-the-effects-of-dopamine-on-renal-functions-of-neonatal-piglets
#20
Anthony Chin, Linh Nguyen O'Conner, Jayant Radhakrishnan, Linda Fornell, Eunice John
In this study, we observed the effects of moderate and high doses of dopamine on the renal functions of neonatal piglets during endotoxic shock. We found that fluid therapy alone was better at maintaining cardiac index and preventing elevation of systemic vascular resistance, than dopamine at 10 and at 20 microg/kg/min. Furthermore, urine output and glomerular filtration rate were reduced by dopamine. Following endotoxin administration dopamine decreased SVR and maintained a CI better than fluid alone. However, in spite of a better CI, greater deterioration in renal functions occurred in the dopamine groups as compared to the fluid group...
2002: Biology of the Neonate
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