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Neonatal hypotension

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https://www.readbyqxmd.com/read/28077740/the-jarisch-herxheimer-reaction-after-antibiotic-treatment-of-spirochetal-infections-a-review-of-recent-cases-and-our-understanding-of-pathogenesis
#1
REVIEW
Thomas Butler
Within 24 hours after antibiotic treatment of the spirochetal infections syphilis, Lyme disease, leptospirosis, and relapsing fever (RF), patients experience shaking chills, a rise in temperature, and intensification of skin rashes known as the Jarisch-Herxheimer reaction (JHR) with symptoms resolving a few hours later. Case reports indicate that the JHR can also include uterine contractions in pregnancy, worsening liver and renal function, acute respiratory distress syndrome, myocardial injury, hypotension, meningitis, alterations in consciousness, seizures, and strokes...
January 11, 2017: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/28030871/obesity-and-neonatal-cord-blood-gas-results-at-cesarean-effect-of-intraoperative-blood-pressure
#2
Mark F Powell, Charity J Morgan, Jessica A Cantu, Yasser Sakawi, Joseph R Biggio, Alan T N Tita, Jeff M Szychowski, Rodney K Edwards
Objective Our aims were to evaluate whether there is an inverse association between body mass index (BMI) and umbilical artery pH and to investigate the contribution of intraoperative hypotension on the umbilical artery pH. Study Design We conducted a retrospective cohort study of all women with a nonanomalous singleton at 37 to 41 weeks who underwent a scheduled cesarean delivery under spinal anesthesia at our facility from January 2006 to March 2012. The primary outcome was the proportion of patients in each BMI category with arterial cord pH < 7...
December 28, 2016: American Journal of Perinatology
https://www.readbyqxmd.com/read/28026887/combined-spinal-epidural-anesthesia-with-hypobaric-ropivacaine-in-sitting-position-significantly-increases-the-incidence-of-hypotension-in-parturients-undergoing-cesarean-section
#3
Zhendong Xu, Fuyi Shen, Yueqi Zhang, Yiyi Tao, Xiubing Chen, Zhiqiang Liu
AIM: Maternal position during induction of combined spinal-epidural anesthesia (CSEA) may affect hemodynamics and block characteristics. This study aimed to assess whether the sitting position is more likely to induce hypotension and higher block level than the lateral position in CSEA with hypobaric ropivacaine. METHODS: Ninety American Society of Anesthesiologists physical status I and II parturients undergoing elective cesarean section were randomized into three groups: the sitting, left-lateral, and right-lateral position groups...
December 27, 2016: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/28009319/-ultrasound-monitoring-of-central-and-cerebral-hemodynamics-during-the-treatment-of-arterial-hypotension-in-preterm-infants
#4
A Zakrevskyy, O Karapetyan, V Agashkov, K Kosenko
The purpose of the study was to evaluate and identify patterns of changes in central and cerebral hemodynamics in neonates with low and extremely low birth weight and birth asphyxia, in order to achieve the early diagnosis of disorders of the central hemodynamics and autoregulation of cerebral blood flow, for timely fluid correction and inotropic therapy. Observation data on 44 preterm infants who were treated at the Kharkiv City Perinatal Centre and Regional Children's Clinical Hospital №1 of Kharkiv has been analyzed...
November 2016: Georgian Medical News
https://www.readbyqxmd.com/read/27984316/venoarterial-extracorporeal-life-support-for-neonatal-respiratory-failure-indications-and-impact-on-mortality
#5
Nicolas A Bamat, Sasha J Tharakan, James T Connelly, Holly L Hedrick, Scott A Lorch, Natalie E Rintoul, Susan B Williams, Kevin C Dysart
Venoarterial (VA) extracorporeal life support (ECLS) for neonatal respiratory failure is associated with increased mortality compared to venovenous (VV) ECLS. It is unclear if this is a causal relationship or reflects differences in baseline disease severity between infants managed with these two strategies. Our objective was to identify clinical variables associated with the preferential selection of VA over VV ECLS, as these may confound the association between VA ECLS and increased mortality. We identified documented indications for preferential VA selection through chart review...
December 13, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/27977557/safety-of-high-dose-acyclovir-in-infants-with-suspected-and-confirmed-neonatal-herpes-simplex-virus-infections
#6
Jessica E Ericson, Martyn Gostelow, Julie Autmizguine, Christoph P Hornik, Reese H Clark, Daniel K Benjamin, P Brian Smith
BACKGROUND: Acyclovir is used to treat herpes simplex virus (HSV) disease in infants. Treatment with high dose acyclovir, 60 mg/kg/day, is recommended; however, the safety of this dosage has not been assessed in the past 15 years, and this dosage is not currently approved for infants by the US Food and Drug Administration. METHODS: We included infants with neonatal HSV disease treated with ≥14 days of intravenous acyclovir starting in the first 120 days of life admitted to 1 of 42 neonatal intensive care units managed by the Pediatrix Medical Group from 2002-2012...
December 12, 2016: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/27964765/arginine-vasopressin-therapy-in-hypotensive-neonates-and-infants-after-cardiac-surgery-response-is-unrelated-to-baseline-ventricular-function
#7
Ilias Iliopoulos, Saul Flores, J N Pratap, David S Cooper, Amy Cassedy, David P Nelson
We hypothesised that infants with ventricular dysfunction after cardiac surgery have impaired haemodynamic response to arginine-vasopressin therapy. We retrospectively reviewed the medical records of neonates and infants treated with arginine-vasopressin within 48 hours of corrective or palliative cardiac surgery who underwent echocardiographic assessment of ventricular function before initiation of therapy. Patients were classified as "responders" if their systolic blood pressure increased by ⩾10% without increase in catecholamine score or if it was maintained with decreased catecholamine score...
December 14, 2016: Cardiology in the Young
https://www.readbyqxmd.com/read/27926905/sildenafil-in-pregnancy-a-systematic-review-of-maternal-tolerance-and-obstetric-and-perinatal-outcomes
#8
Liam Dunn, Ristan Greer, Vicki Flenady, Sailesh Kumar
INTRODUCTION: This systematic review evaluates maternal tolerance and obstetric and perinatal outcomes following sildenafil citrate (SC) use in human pregnancy. DATA SOURCES: Scopus, PubMed, Cochrane Library, Web of Science, Embase, and Google Scholar were searched. Relevant full-text studies including case series and reports in English were included. Publications were excluded if the pregnancy was terminated or if SC was used only at conception. RESULTS: Sixteen studies were included (n = 165)...
December 8, 2016: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/27898415/hypotension-and-adverse-outcomes-in-prematurity-comparing-definitions
#9
Deidre St Peter, Christiana Gandy, Suma B Hoffman
BACKGROUND: In the premature neonate, there is no consensus regarding normal blood pressure (BP). The most common definition used is a mean arterial BP (MAP) less than the gestational age (GA); however, studies indicate that the neuroprotective mechanism of autoregulation is lost below a MAP of 30 mm Hg. OBJECTIVE: To determine whether hypotension defined as MAP <30 mm Hg or MAP less than the infant's GA better predicts adverse outcomes of intraventricular hemorrhage (IVH) and death...
November 30, 2016: Neonatology
https://www.readbyqxmd.com/read/27896911/the-timing-and-prevalence-of-intraoperative-hypotension-in-infants-undergoing-laparoscopic-pyloromyotomy-at-a-tertiary-pediatric-hospital
#10
Allan F Simpao, Luis M Ahumada, Jorge A Gálvez, Christopher P Bonafide, Elicia C Wartman, William Randall England, Arul M Lingappan, Todd J Kilbaugh, Abbas F Jawad, Mohamed A Rehman
BACKGROUND: Intraoperative hypotension may be associated with adverse outcomes in children undergoing surgery. Infants and neonates under 6 months of age have less autoregulatory cerebral reserve than older infants, yet little information exists regarding when and how often intraoperative hypotension occurs in infants. AIMS: To better understand the epidemiology of intraoperative hypotension in infants, we aimed to determine the prevalence of intraoperative hypotension in a generally uniform population of infants undergoing laparoscopic pyloromyotomy...
January 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/27857456/magnetic-resonance-imaging-spectrum-of-perinatal-hypoxic-ischemic-brain-injury
#11
Binoj Varghese, Rose Xavier, V C Manoj, M K Aneesh, P S Priya, Ashok Kumar, V K Sreenivasan
Perinatal hypoxic-ischemic brain injury results in neonatal hypoxic-ischemic encephalopathy and serious long-term neurodevelopmental sequelae. Magnetic resonance imaging (MRI) of the brain is an ideal and safe imaging modality for suspected hypoxic-ischemic injury. The pattern of injury depends on brain maturity at the time of insult, severity of hypotension, and duration of insult. Time of imaging after the insult influences the imaging findings. Mild to moderate hypoperfusion results in germinal matrix hemorrhages and periventricular leukomalacia in preterm neonates and parasagittal watershed territory infarcts in full-term neonates...
July 2016: Indian Journal of Radiology & Imaging
https://www.readbyqxmd.com/read/27847698/intrathecal-midazolam-as-an-adjuvant-in-pregnancy-induced-hypertensive-patients-undergoing-an-elective-caesarean-section-a-clinical-comparative-study
#12
Ravichandra Dodawad, Sumalatha G B, Sandeep Pandarpurkar, Parashuram Jajee
BACKGROUND: A pain-free postoperative period is essential following a caesarean section so new mothers may care for and bond with their neonates. Intrathecal adjuvants are often administered during this procedure to provide significant analgesia, but they may also have bothersome side effects. Intrathecal midazolam produces effective postoperative analgesia with no significant side effects. OBJECTIVES: This prospective, randomized, double-blind study was designed to compare the analgesic efficacy and safety of intrathecal midazolam vs...
October 2016: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/27826711/safety-of-enalapril-in-infants-admitted-to-the-neonatal-intensive-care-unit
#13
Lawrence C Ku, Kanecia Zimmerman, Daniel K Benjamin, Reese H Clark, Christoph P Hornik, P Brian Smith
Enalapril is used to treat hypertension and congestive heart failure in infants. However, enalapril is not labeled for neonates, and safety data in infants are sparse. To evaluate the safety of enalapril in young infants, we conducted a retrospective cohort study of infants who were exposed to enalapril in the first 120 days of life and were cared for in 348 neonatal intensive care units from 1997 to 2012. We determined the proportion of exposed infants who developed adverse events, including death, hypotension requiring pressors, hyperkalemia, and elevated serum creatinine...
November 8, 2016: Pediatric Cardiology
https://www.readbyqxmd.com/read/27789620/scalp-congenital-hemangioma-with-associated-high-output-cardiac-failure-in-a-premature-infant-case-report-and-review-of-literature
#14
Sumedh S Shah, Brian M Snelling, Samir Sur, Alexandra R Ramnath, Emmalee S Bandstra, Dileep R Yavagal
INTRODUCTION: Scalp congenital hemangiomas (CHs) are rare vascular malformations among infants; they can be associated with an array of complications, including cardiac and cosmetic issues. Here, we report the endovascular treatment of a premature infant with a suspected large right parietal scalp hemangioma and associated high-output cardiac failure. CASE DESCRIPTION: A two-day-old female premature infant (29 weeks gestational age; 1330 g birth weight) was referred by the neonatologists to our department for consultation and potential treatment of a large right parietal CH causing abrupt hypotension and high-output cardiac failure...
October 27, 2016: Interventional Neuroradiology
https://www.readbyqxmd.com/read/27773638/diagnosis-and-risk-factors-of-acute-kidney-injury-in-very-low-birth-weight-infants
#15
Ankana Daga, Fredrick Dapaah-Siakwan, Sharina Rajbhandari, Cassandra Arevalo, Agnes Salvador
BACKGROUND: Acute kidney injury (AKI) is common in critically ill premature infants. There is a lack of consensus on the diagnostic definition of AKI in very low birth weight (VLBW) infants. The primary aim of this study was to determine the incidence and risk factors for AKI in VLBW infants using the AKI network (AKIN) and pRIFLE (pediatric Risk, Injury, Failure, Loss, End-Stage) criteria and to evaluate whether Clinical Risk Index for Babies (CRIB II) score is a predictor of AKI. The secondary objective was to determine the extent of agreement between the AKIN and pRIFLE criteria in the diagnosis of AKI in VLBW infants...
September 28, 2016: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/27750254/temporal-profile-of-circulating-micrornas-after-global-hypoxia-ischemia-in-newborn-piglets
#16
Håvard Tetlie Garberg, Marianne U Huun, Lars O Baumbusch, Monica Åsegg-Atneosen, Rønnaug Solberg, Ola Didrik Saugstad
BACKGROUND: There is a lack of reliable biomarkers that can identify and grade acute hypoxic-ischemic encephalopathy in newborns. MicroRNAs (miRNA) are short, non-coding strands of RNA that are released into the circulation in response to tissue stress and injury. Some miRNAs are highly tissue specific and thus may potentially be non-invasive biomarkers of neonatal hypoxic-ischemic brain injury. OBJECTIVE: The aim of this study was to characterize the temporal expression of selected circulating miRNAs in a clinically relevant piglet model of neonatal hypoxia-ischemia (HI)...
October 18, 2016: Neonatology
https://www.readbyqxmd.com/read/27747714/severe-hypotension-after-amlodipine-use-for-hypertension-in-a-newborn-on-beta-blocker-therapy-for-thyrotoxicosis
#17
Mohammad Khassawneh, Nedaa Al-Ghazo
A 35-year-old woman with a 9-year history of Grave's disease delivered a male infant weighing 2,210 g at 32 weeks of gestation by caesarean section. The neonate developed thyrotoxicosis and, at the age of 24 h, was treated with oral carbimazole (500 µg every 8 h) and propranolol (2 mg/kg/day in two divided doses). He subsequently developed hypertension on day 4, which required therapy with amlodipine (0.1 mg once daily). Severe hypotension developed within 24 h and required discontinuation of amlodipine, with initiation of intravenous inotropic support with dopamine and dobutamine (at a rate of 20 µg/kg/min)...
December 2015: Drug Safety—Case Reports
https://www.readbyqxmd.com/read/27746565/evaluation-of-antihypotensive-techniques-for-cesarean-section-under-spinal-anesthesia-rapid-crystalloid-hydration-versus-intravenous-ephedrine
#18
Kalpana Rajendra Kulkarni, Amruta Girish Naik, Sunetra Girish Deshpande
BACKGROUND: Spinal anesthesia is a preferred technique over general anesthesia for cesarean delivery. It avoids maternal airway related complications, aspiration and neonatal depression. However hypotension following spinal anesthesia can lead to decrease in uterine blood flow and neonatal hypoxia. AIMS: We aimed to evaluate the efficacy of 15 mL.kg- 1of crystalloid preloading versus prophylactic intravenous bolus of 10 mg ephedrine as an antihypotensive measure for cesarean section...
September 2016: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/27720613/an-open-label-randomized-controlled-clinical-trial-for-comparison-of-continuous-phenylephrine-versus-norepinephrine-infusion-in-prevention-of-spinal-hypotension-during-cesarean-delivery
#19
M C Vallejo, A F Attaallah, O M Elzamzamy, D T Cifarelli, A L Phelps, G R Hobbs, R E Shapiro, P Ranganathan
BACKGROUND: During spinal anesthesia for cesarean delivery phenylephrine is the vasopressor of choice but can cause bradycardia. Norepinephrine has both β- and α-adrenergic activity suitable for maintaining blood pressure with less bradycardia. We hypothesized that norepinephrine would be superior to phenylephrine, requiring fewer rescue bolus interventions to maintain blood pressure. METHODS: Eighty-five parturients having spinal anesthesia for elective cesarean delivery were randomized to Group P (phenylephrine 0...
August 28, 2016: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/27712890/acute-gastrointestinal-compromise-in-neonates-with-congenital-diaphragmatic-hernia-prior-to-repair
#20
Catherine Fox, Michael Stewart, Sebastian K King, Neil Patel
BACKGROUND: Congenital diaphragmatic hernia (CDH) affects 1 in 3000 live births. Modern management strategies include delayed repair of the diaphragm to permit pre-operative optimization of cardiorespiratory status. We describe a cohort of neonates in whom early emergency operative intervention was required for potentially fatal intestinal compromise. METHODS: A retrospective review was performed of all neonatal CDH patients managed at a tertiary center in an 8-year period (2005-2012)...
December 2016: Journal of Pediatric Surgery
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