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Hypotension and infant

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https://www.readbyqxmd.com/read/28182021/procedural-moderate-sedation-with-ketamine-in-pediatric-critical-care-unit
#1
Tarek R Hazwani, Hala Al-Alem
OBJECTIVE: To evaluate the safety and efficacy of moderate sedation in the Pediatric Intensive Care Unit (PICU) settings according to moderate sedation protocol using ketamine and midazolam and to determine areas for the improvement in our clinical practice. SETTINGS AND DESIGN: A retrospective study was conducted in the PICU. MATERIALS AND METHODS: Retrospective chart review was performed for patients who had received moderate sedation between January and the end of December 2011 and who are eligible to inclusion criteria...
January 2017: Avicenna Journal of Medicine
https://www.readbyqxmd.com/read/28167590/chikungunya-and-neonatal-immunity-fatal-vertically-transmitted-chikungunya-infection
#2
Tracy Evans-Gilbert
Chikungunya is a mosquito-borne infectious disease that has emerged as a global pathogen. The virus can pass vertically from mother to child especially during the perinatal period, with an intrapartum vertical transmission rate of 50%. Approximately half of the neonates infected with chikungunya present with severe symptoms and infrequently death. This report summarizes two severe cases of vertically transmitted neonatal chikungunya infection. One case was confirmed by real-time reverse transcription polymerase chain reaction and the other fulfilled clinical and epidemiological criteria...
February 6, 2017: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/28141899/intravenous-midazolam-infusion-for-sedation-of-infants-in-the-neonatal-intensive-care-unit
#3
REVIEW
Eugene Ng, Anna Taddio, Arne Ohlsson
BACKGROUND: Proper sedation for neonates undergoing uncomfortable procedures may reduce stress and avoid complications. Midazolam is a short-acting benzodiazepine that is used increasingly in neonatal intensive care units (NICUs). However, its effectiveness as a sedative in neonates has not been systematically evaluated. OBJECTIVES: Primary objeciveTo assess the effectiveness of intravenous midazolam infusion for sedation, as evaluated by behavioural and/or physiological measurements of sedation levels, in critically ill neonates in the NICU...
January 31, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28141842/dopamine-therapy-does-not-affect-cerebral-autoregulation-during-hypotension-in-newborn-piglets
#4
Vibeke Ramsgaard Eriksen, Martin Bo Rasmussen, Gitte Holst Hahn, Gorm Greisen
BACKGROUND: Hypotensive neonates who have been treated with dopamine have poorer neurodevelopmental outcome than those who have not been treated with dopamine. We speculate that dopamine stimulates adrenoceptors on cerebral arteries causing cerebral vasoconstriction. This vasoconstriction might lead to a rightward shift of the cerebral autoregulatory curve; consequently, infants treated with dopamine would have a higher risk of low cerebral blood flow at a blood pressure that is otherwise considered "safe"...
2017: PloS One
https://www.readbyqxmd.com/read/28117531/late-onset-circulatory-collapse-of-prematurity
#5
Masahiko Kawai
Some very-low-birth-weight (VLBW) infants develop refractory hypotension, which is resistant to intravenous volume expanders and inotropes, but responds to exogenous glucocorticoid dramatically.(1-8) Such refractory hypotension usually occurs just after birth or within the early neonatal period (<Day 7). However, cases of refractory hypotension after the early neonatal period (>Day 7) have been reported since 2000 in Japan.(9) In typical cases, infants are stabilized for a period within the early neonatal period, and the sudden onset of circulatory collapse then subsequently occurs...
January 24, 2017: Pediatrics International: Official Journal of the Japan Pediatric Society
https://www.readbyqxmd.com/read/28066825/a-blinded-randomised-placebo-controlled-trial-investigating-the-efficacy-of-morphine-analgesia-for-procedural-pain-in-infants-trial-protocol
#6
Rebeccah Slater, Caroline Hartley, Fiona Moultrie, Eleri Adams, Ed Juszczak, Richard Rogers, Jane E Norman, Chetan Patel, Kayleigh Stanbury, Amy Hoskin, Gabrielle Green
Infant pain has both immediate and long-term negative consequences, yet in clinical practice it is often undertreated. To date, few pain-relieving drugs have been tested in infants. Morphine is a potent analgesic that provides effective pain relief in adults, but there is inconclusive evidence for its effectiveness in infants. The purpose of this study is to establish whether oral morphine provides effective analgesia for procedural pain in infants. A blinded, placebo-controlled, parallel-group randomized, phase II, clinical trial will be undertaken to determine whether morphine sulphate administered orally prior to clinically-required retinopathy of prematurity (ROP) screening and heel lancing provides effective analgesia...
November 15, 2016: Wellcome Open Res
https://www.readbyqxmd.com/read/28030871/obesity-and-neonatal-cord-blood-gas-results-at-cesarean-effect-of-intraoperative-blood-pressure
#7
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/28009319/-ultrasound-monitoring-of-central-and-cerebral-hemodynamics-during-the-treatment-of-arterial-hypotension-in-preterm-infants
#8
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/27994573/sudden-infant-death-syndrome-role-of-trigeminocardiac-reflex-a-review
#9
REVIEW
Gyaninder Pal Singh, Tumul Chowdhury, Barkha Bindu, Bernhard Schaller
Sudden infant death syndrome (SIDS) is an unexplained death in infants, which usually occurs during sleep. The cause of SIDS remains unknown and multifactorial. In this regard, the diving reflex (DR), a peripheral subtype of trigeminocardiac reflex (TCR), is also hypothesized as one of the possible mechanisms for this condition. The TCR is a well-established neurogenic reflex that manifests as bradycardia, hypotension, apnea, and gastric hypermotility. The TCR shares many similarities with the DR, which is a significant physiological adaptation to withstand hypoxia during apnea in many animal species including humans in clinical manifestation and mechanism of action...
2016: Frontiers in Neurology
https://www.readbyqxmd.com/read/27984316/venoarterial-extracorporeal-life-support-for-neonatal-respiratory-failure-indications-and-impact-on-mortality
#10
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
#11
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
#12
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/27915200/effects-of-prophylactic-indomethacin-on-vasopressor-dependent-hypotension-in-extremely-preterm-infants
#13
Melissa Liebowitz, Jane Koo, Andrea Wickremasinghe, Isabel Elaine Allen, Ronald I Clyman
OBJECTIVE: To determine whether a moderate-to-large patent ductus arteriosus (PDA) is responsible for vasopressor-dependent hypotension, occurring at the end of the first postnatal week. STUDY DESIGN: We performed a retrospective, double cohort controlled study of infants delivered at ≤27(+6) weeks' gestation (n = 313). From January 2004 through April 2011, all infants were treated with prophylactic indomethacin ([PINDO] epoch). From May 2011 through December 2015, no infant was treated with indomethacin until at least 8 postnatal days (conservative epoch)...
March 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/27914885/blind-percutaneous-liver-biopsy-in-infants-and-children-comparison-of-safety-and-efficacy-of-percussion-technique-and-ultrasound-assisted-technique
#14
RANDOMIZED CONTROLLED TRIAL
Engy A Mogahed, Yasmeen A Mansy, Yasmeen Al Hawi, Rokaya El-Sayed, Mona El-Raziky, Hanaa El-Karaksy
BACKGROUND AND STUDY AIMS: Liver biopsy remains the most reliable method to diagnose various hepatic disorders in children. We aimed to assess the technical success and complication rate of ultrasound (US) assisted percutaneous liver biopsy versus transthoracic percussion guided technique in paediatrics. PATIENTS AND METHODS: This randomized controlled study included all cases performing liver biopsy at Paediatric Hepatology Unit, Cairo University Paediatric Hospital over 12months...
December 2016: Arab Journal of Gastroenterology: the Official Publication of the Pan-Arab Association of Gastroenterology
https://www.readbyqxmd.com/read/27914140/comparison-of-the-mortality-and-in-hospital-outcomes-of-preterm-infants-treated-with-ibuprofen-for-patent-ductus-arteriosus-with-or-without-clinical-symptoms-attributable-to-the-patent-ductus-arteriosus-at-the-time-of-ibuprofen-treatment
#15
Hani Yoo, Jin A Lee, Sohee Oh, Young Hwa Jung, Jin A Sohn, Seung Han Shin, Chang Won Choi, Ee Kyung Kim, Han Suk Kim, Beyong Il Kim
The aim of this study was to assess the differences in the mortality and in-hospital outcomes of preterm infants with < 28 weeks of gestation who received ibuprofen treatment according to the presence of clinical symptoms (any of oliguria, hypotension, or moderate to severe respiratory difficulty) attributable to hemodynamically-significant patent ductus arteriosus (hsPDA) at the time of first ibuprofen treatment. In total, 91 infants born from April 2010 to March 2015 were included. Fourteen infants (15...
January 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/27912926/acute-management-of-refractory-and-unstable-pediatric-supraventricular-tachycardia
#16
Jonathan Lewis, Gaurav Arora, Dana L Tudorascu, Robert W Hickey, Richard A Saladino, Mioara D Manole
OBJECTIVE: To characterize the management of acute pediatric supraventricular tachycardia (SVT), placing special emphasis on infants, patients refractory to adenosine (refractory SVT), and patients with hypotension, poor perfusion, or altered mental status (unstable SVT). STUDY DESIGN: Retrospective cohort study of patients 0-18 years of age without congenital heart disease who presented to our pediatric hospital from January 2003 to December 2012 for the treatment of acute SVT...
November 22, 2016: Journal of Pediatrics
https://www.readbyqxmd.com/read/27898415/hypotension-and-adverse-outcomes-in-prematurity-comparing-definitions
#17
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
#18
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
#19
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/27826711/safety-of-enalapril-in-infants-admitted-to-the-neonatal-intensive-care-unit
#20
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...
January 2017: Pediatric Cardiology
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