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Hypotension and infant

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https://www.readbyqxmd.com/read/28629239/cortisol-precursors-in-neonates-with-vasopressor-resistant-hypotension-in-relationship-to-demographic-characteristics
#1
Abdelmoneim Khashana, Hoda Ahmed, Amal Ahmed, Amina Abdelwahab, Timo Saarela, Mika Rämet, Mikko Hallman
OBJECTIVE: To correlate between cortisol precursors in neonates with vasopressor resistant hypotension and demographic characteristics. METHODS: We investigated 48 neonates with vasopressor-resistant hypotension. Gestation at birth ranged from 34 to 42 weeks and postnatal age from 4 to 14 days. Cortisol and precursor steroids were measured soon after the onset of volume expansion and inotropes for treatment of shock. Their concentrations were determined using liquid chromatography-mass spectrometry...
June 19, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28542662/-dengue-with-unusual-clinical-features-in-an-infant-case-report
#2
Nina Méndez-Domínguez, Kikey Achach-Medina, Yareni María Morales-Gual, Salvador Gómez-Carro
The state of Yucatan, in Mexico, is an endemic area for dengue. During 2015, there was an unpredicted increase in the number of expected cases of dengue fever. OBJECTIVE: To describe and analyse the clinical presentation, progress, and management of a case of dengue infection with non-specific clinical manifestations in an infant which resulted in a dengue shock syndrome. CASE REPORT: One month old infant admitted to hospital with a generalised rash and a history of being bitten by an insect...
April 2017: Revista Chilena de Pediatría
https://www.readbyqxmd.com/read/28538235/what-should-we-do-about-low-blood-pressure-in-preterm-infants
#3
Eugene M Dempsey
The management of preterm infants with low blood pressure soon after birth remains unresolved. The definition of what constitutes low blood pressure is uncertain. At birth, mean blood pressure appears to be gestation specific and increases in the first few days of life. Antenatal steroids, delayed cord clamping, and the avoidance of mechanical ventilation are all associated with higher mean blood pressure and less hypotension after birth. Rates of hypotension of 15-50% have been reported in various studies of extremely preterm infants...
2017: Neonatology
https://www.readbyqxmd.com/read/28518133/an-evaluation-of-hydrocortisone-dosing-for-neonatal-refractory-hypotension
#4
E S Peeples
OBJECTIVE: The objective of the study was to compare blood pressure, vasoactive medication requirements and adverse outcomes after administration of high- versus low-dose hydrocortisone (HC) in preterm infants. STUDY DESIGN: This is a retrospective analysis of 106 infants ⩽28 weeks gestational age with hypotension requiring vasoactive infusions and high-dose (4 mg kg(-1) per day, n=50), low-dose (1 to 3 mg kg(-1) per day, n=20) or no HC (n=36) from 2011 to 2015...
May 18, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28489641/differences-in-blood-pressure-in-infants-after-general-anesthesia-compared-to-awake-regional-anesthesia-gas-study-a-prospective-randomized-trial
#5
M E McCann, D E Withington, S J Arnup, A J Davidson, N Disma, G Frawley, N S Morton, G Bell, R W Hunt, D C Bellinger, D M Polaner, A Leo, A R Absalom, B S von Ungern-Sternberg, F Izzo, P Szmuk, V Young, S G Soriano, J C de Graaff
BACKGROUND: The General Anesthesia compared to Spinal anesthesia (GAS) study is a prospective randomized, controlled, multisite, trial designed to assess the influence of general anesthesia (GA) on neurodevelopment at 5 years of age. A secondary aim obtained from the blood pressure data of the GAS trial is to compare rates of intraoperative hypotension after anesthesia and to identify risk factors for intraoperative hypotension. METHODS: A total of 722 infants ≤60 weeks postmenstrual age undergoing inguinal herniorrhaphy were randomized to either bupivacaine regional anesthesia (RA) or sevoflurane GA...
May 4, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28486234/low-plasma-protein-levels-at-birth-are-associated-with-poor-cardiovascular-adaptation-and-serious-adverse-outcome-in-infants-with-gestational-age-32-weeks-the-proh%C3%A3-mie-study
#6
Francesco Bonsante, Duksha Ramful, Sylvain Samperiz, Sandrine Daniel, Anais Godeluck, Pierre-Yves Robillard, Karim Jamal-Bey, Jean-Bernard Gouyon, Christine Binquet, Silvia Iacobelli
BACKGROUND: Retrospective studies suggest that early hypoproteinemia has prognostic value for adverse outcome in preemies, but the underlying pathophysiology is unknown. We hypothesized that the prognostic relevance of hypoproteinemia could be related to its association with impaired cardiovascular function and organ perfusion during transition. OBJECTIVES: To describe the plasma protein status and the measures of cardiovascular function according to the outcome in infants <32 weeks' gestation...
May 10, 2017: Neonatology
https://www.readbyqxmd.com/read/28473717/safety-and-tolerance-of-propranolol-in-neonates-with-severe-infantile-hemangiomas-a-prospective-study
#7
Yi Ji, Siyuan Chen, Bo Xiang, Yang Yang, Liqing Qiu
Although the efficacy of propranolol for the treatment of infantile hemangiomas (IHs) has been well documented, there is a paucity of clinical data regarding the safety and tolerance of propranolol in neonates. A prospective study of 51 patients less than 30 days of age with severe IH was conducted. All patients were admitted to the hospital for monitoring during initial propranolol treatment at day 0 with dose adjustments at days 7 and 28. Heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), blood glucose (BG) levels and potential side effects were evaluated during treatment...
May 4, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28471441/how-to-assess-hemodynamic-status-in-very-preterm-newborns-in-the-first-week-of-life
#8
G Escourrou, L Renesme, E Zana, A Rideau, M O Marcoux, E Lopez, G Gascoin, P Kuhn, P Tourneux, I Guellec, C Flamant
BACKGROUND: Assessing hemodynamic status in preterm newborns is an essential task, as many studies have shown increased morbidity when hemodynamic parameters are abnormal. Although oscillometric monitoring of arterial blood pressure (BP) is widely used due to its simplicity and lack of side effects, these values are not always correlated with microcirculation and oxygen delivery. OBJECTIVES: This review focuses on different tools for the assessment of hemodynamic status in preterm newborns...
May 4, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28462900/hyperdehydroepiandrosterone-in-neonates-with-hypoxic-ischemic-encephalopathy-and-circulatory-collapse
#9
Abdelmoneim Khashana, Engy Ahmed
BACKGROUND: Circulatory collapse is a very common complication of the critical illnesses in neonates including neonates with hypoxic ischemic encephalopathy; it can be the end result and cause of death of several conditions. Often, despite treatment with fluid resuscitation and vasopressor agents, circulatory collapse persist, and blood pressure can remain critically low, compromising adequate blood flow to vital organs and brain. Low blood pressure has been associated with increased mortality...
April 12, 2017: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/28453903/perfusion-monitoring-and-intraventricular-hemorrhage-in-preterm-infants
#10
Akio Ishiguro
Cardiovascular instability in preterm infants during the early postnatal period correlates with the development of intraventricular hemorrhage (IVH). Due to the correlation between hypotension and fluctuation of blood pressure, treatment especially aimed at hypotension has been attempted to prevent IVH. However, these attempts have seemed to result in failure. Recently, several novel perfusion markers have been found to be correlated with the development of IVH, and they are of current interest in cardiovascular management...
April 28, 2017: Pediatrics International: Official Journal of the Japan Pediatric Society
https://www.readbyqxmd.com/read/28452098/impact-of-bradycardia-or-asystole-on-neonatal-cardiopulmonary-resuscitation-at-birth
#11
Vasantha H S Kumar, Annie Skrobacz, Changxing Ma
BACKGROUND: Fetal hypoxia from intrapartum events can lead to absent heart rate (HR) or bradycardia (BC) at birth requiring aggressive neonatal resuscitation. Neonatal resuscitation guidelines do not differentiate infants with bradycardia (HR<100/min) from absent HR at birth. As HR is the primary determinant of resuscitation, we hypothesize that infants with no HR at 1 minute would require more extensive resuscitation with worse clinical outcomes compared to infants with bradycardia at 1minute...
April 28, 2017: Pediatrics International: Official Journal of the Japan Pediatric Society
https://www.readbyqxmd.com/read/28444697/population-pharmacokinetics-of-dexmedetomidine-in-infants
#12
Rachel G Greenberg, Huali Wu, Matthew Laughon, Edmund Capparelli, Stevie Rowe, Kanecia O Zimmerman, P Brian Smith, Michael Cohen-Wolkowiez
Despite limited pharmacokinetic (PK) data, dexmedetomidine is increasingly being used off-label for sedation in infants. We aimed to characterize the developmental PK changes of dexmedetomidine during infancy. In this open-label, single-center PK study of dexmedetomidine in infants receiving dexmedetomidine per clinical care, ≤10 blood samples per infant were collected. A set of structural PK models and residual error models were explored using nonlinear mixed-effects modeling in NONMEM. Covariates including postmenstrual age (PMA), serum creatinine, and recent history of cardiac surgery requiring cardiopulmonary bypass were investigated for their influence on PK parameters...
April 25, 2017: Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28428900/asymptomatic-severe-vagal-and-sympathetic-cardiac-denervation-in-holmes-adie-s-syndrome
#13
B Estañol, R C Callejas-Rojas, S Cortés, R Martínez-Memije, O Infante-Vázquez, G Delgado-García
A 40-year-old woman was found to have bilateral Adie's pupils and generalized muscle stretch areflexia. She did not have orthostatic hypotension but, in an ECG strip in the office, she appeared to have an almost fixed heart rate. We thus studied the heart rate variability (HRV) and the systolic blood pressure variability (SBPV) in supine and standing position and also during rhythmic breathing. We found a decreased HRV in the time domain with very low standard deviation in supine and standing position and during rhythmic breathing...
2017: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/28428252/low-frequency-blood-pressure-oscillations-and-inotrope-treatment-failure-in-premature-infants
#14
Zachary Andrew Vesoulis, Jessica Hao, Christopher McPherson, Nathalie El Ters, Amit M Mathur
BACKGROUND: The underlying mechanism as to why some hypotensive preterm infants do not respond to inotropic medications remains unclear. For these infants, we hypothesize that impaired vasomotor function is a significant factor and is manifested through a decrease in low-frequency blood pressure variability across regulatory components of vascular tone. METHODS: Infants born 28 weeks estimated gestational age underwent prospective recording of mean arterial blood pressure (MABP) for 72h after birth...
April 20, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/28421173/cerebral-autoregulation-brain-injury-and-the-transitioning-premature-infant
#15
REVIEW
Zachary A Vesoulis, Amit M Mathur
Improvements in clinical management of the preterm infant have reduced the rates of the two most common forms of brain injury, such as severe intraventricular hemorrhage and white matter injury, both of which are contributory factors in the development of cerebral palsy. Nonetheless, they remain a persistent challenge and are associated with a significant increase in the risk of adverse neurodevelopment outcomes. Repeated episodes of ischemia-reperfusion represent a common pathway for both forms of injury, arising from discordance between systemic blood flow and the innate regulation of cerebral blood flow in the germinal matrix and periventricular white matter...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28419639/differences-in-intraoperative-hemodynamics-between-spinal-and-general-anesthesia-in-infants-undergoing-pyloromyotomy
#16
Caleb Ing, Lena S Sun, Alexander F Friend, Minjae Kim, Mitchell F Berman, William Paganelli, Guohua Li, Robert K Williams
BACKGROUND: Hypotension and bradycardia are known side effects of spinal anesthesia in pregnant women undergoing cesarean section and adults undergoing other surgical procedures. Whether children experience similar hemodynamic changes is unclear. AIMS: The purpose of this study is to evaluate hemodynamic effects of spinal anesthesia compared to general anesthesia in a cohort of healthy infants. METHODS: The University of Vermont Medical Center almost exclusively used spinal anesthesia for infant pyloromyotomy surgery between 2008 and 2013, while Columbia University Medical Center relied on general anesthesia...
July 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28399330/arginine-supplementation-for-prevention-of-necrotising-enterocolitis-in-preterm-infants
#17
REVIEW
Prakeshkumar S Shah, Vibhuti S Shah, Lauren E Kelly
BACKGROUND: Decreased concentration of nitric oxide has been proposed as one of the possible cellular mechanisms of necrotising enterocolitis (NEC). Arginine can act as a substrate for production of nitric oxide in the tissues, and arginine supplementation may help to prevent NEC. OBJECTIVES: To examine the effect of arginine supplementation (administered by any route) on the incidence of NEC in preterm neonates. To conduct subgroup analyses based on the dose of arginine and the gestational age of participants (≤ 32 weeks, > 32 weeks)...
April 11, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28397438/intraventricular-hemorrhage-in-neonates-born-from-23-to-26-weeks-of-gestation-retrospective-analysis-of-risk-factors
#18
Dawid Szpecht, Irmina Nowak, Paulina Kwiatkowska, Marta Szymankiewicz, Janusz Gadzinowski
BACKGROUND: The study aim was to determine the incidence and analyze risk factors of IVH stage 3 and 4 in infants born before 26 weeks of gestation. OBJECTIVES: A retrospective analysis of 110 preterm babies (23-26 weeks of gestation) hospitalized from 2009 to 2014 at the Department of Neonatology of Poznan University of Medical Sciences was performed. MATERIAL AND METHODS: In the study group there were 29 (26.4%) children in the 23rd-24th weeks of pregnancy and 81 (73...
January 2017: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
https://www.readbyqxmd.com/read/28304253/ventricular-parasystole-in-a-neonatal-rhesus-macaque-macaca-mulatta
#19
Dalis E Collins, Brandy L Dozier, Jeffrey J Stanton, Lois Ma Colgin, Rhonda MacAllister
A 6-d-old Indian-origin female rhesus macaque (Macaca mulatta) presented with bradycardia shortly after sedation with ketamine. No other cardiac abnormalities were apparent. Approximately 2 wk after the initial presentation, the macaque was again bradycardic and exhibited a regularly irregular arrhythmia on a prestudy examination. ECG, echocardiography, blood pressure measurement, SpO2 assessment, and a CBC analysis were performed. The echocardiogram and bloodwork were normal, but the infant was hypotensive at the time of echocardiogram...
December 1, 2016: Comparative Medicine
https://www.readbyqxmd.com/read/28302697/abstention-or-intervention-for-isolated-hypotension-in-the-first-3%C3%A2-days-of-life-in-extremely-preterm-infants-association-with-short-term-outcomes-in-the-epipage-2-cohort-study
#20
Xavier Durrmeyer, Laetitia Marchand-Martin, Raphaël Porcher, Geraldine Gascoin, Jean-Christophe Roze, Laurent Storme, Geraldine Favrais, Pierre-Yves Ancel, Gilles Cambonie
OBJECTIVE: To compare outcomes at hospital discharge for preterm infants born before 29 weeks of gestation who had at least one episode of isolated hypotension during their first 72 hours of life for which they did or did not receive antihypotensive treatment. DESIGN: Etude Epidémiologique sur les Petits Ages Gestationnels 2 (EPIPAGE 2) French national prospective population-based cohort study in 2011. SETTING: 60 neonatal intensive care units...
March 16, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
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