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Hypotension and infant

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https://www.readbyqxmd.com/read/29334510/comparing-peri-operative-complications-of-paediatric-and-adult-anaesthesia-a-retrospective-cohort-study-of-81%C3%A2-267-cases
#1
Andrie C Westerkamp, A Fred de Geus, Bouwe Molenbuur, Peter Meyer, J K Götz Wietasch, Michel M R F Struys, Herman G D Hendriks
BACKGROUND: Comparisons of peri-operative complications associated with paediatric (≤16 years) and adult anaesthesia are poorly available, especially in which cardiac surgery, organ transplantation and neurosurgery are involved. OBJECTIVE: The aim of this study was to evaluate the nature and incidence of peri-operative complications that might be due to anaesthesia and to identify independent risk factors for complications in children and adults, including those undergoing cardiac surgery, organ transplantation and neurosurgery...
January 13, 2018: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29301119/cause-and-clinical-presentation-of-anaphylaxis-in-singapore-from-infancy-to-old-age
#2
Si Hui Goh, Jian Yi Soh, Wenyin Loh, Khai Pin Lee, Sze Chin Tan, Wei Jian Kenneth Heng, Irwani Ibrahim, Bee Wah Lee, Wen Chin Chiang
BACKGROUND: The study objective was to compare age-related differences in the cause and clinical presentation of anaphylaxis. METHODS: We conducted a prospective study of patients visiting the emergency department for anaphylaxis. Data were collected from 3 emergency departments from 1 April 2014 to 31 December 2015. Patient electronic records with the diagnoses of allergy, angioedema, urticaria, and anaphylaxis (ICD-9 codes 9953, 9951, 7080, 9950, 7089) were screened and cases fulfilling World Allergy Organisation criteria for anaphylaxis were included...
January 5, 2018: International Archives of Allergy and Immunology
https://www.readbyqxmd.com/read/29290743/use-of-vasopressin-in-neonatal-intensive-care-unit-patients-with-hypotension
#3
Mengwei Ni, Jeffrey R Kaiser, Brady S Moffett, Christopher J Rhee, Jennifer Placencia, Kimberly L Dinh, Joseph L Hagan, Danielle R Rios
OBJECTIVE: To evaluate the safety and efficacy of vasopressin for the treatment of hypotension in patients admitted to neonatal intensive care units (NICUs). METHODS: Vasopressin use in 69 infants admitted to our NICU between 2011 and 2014 was examined. Data evaluated included demographics; serum creatinine, sodium, and lactate concentrations; urine output; and systolic, diastolic, and mean blood pressures (BPs). Parameters prior to vasopressin use were compared to those at maximum dose...
November 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/29279413/association-between-diastolic-blood-pressure-during-pediatric-in-hospital-cardiopulmonary-resuscitation-and-survival
#4
Robert A Berg, Robert M Sutton, Ron W Reeder, John T Berger, Christopher J Newth, Joseph A Carcillo, Patrick S McQuillen, Kathleen L Meert, Andrew R Yates, Rick E Harrison, Frank W Moler, Murray M Pollack, Todd C Carpenter, David L Wessel, Tammara L Jenkins, Daniel A Notterman, Richard Holubkov, Robert F Tamburro, J Michael Dean, Vinay M Nadkarni
Background -Based on laboratory cardiopulmonary resuscitation (CPR) investigations and limited adult data demonstrating that survival depends on attaining adequate arterial diastolic blood pressure (DBP) during CPR, American Heart Association recommends using BP to guide pediatric CPR. However, evidence-based BP targets during pediatric CPR remain an important knowledge gap for CPR guidelines. Methods -All children ≥37 weeks gestation and <19 years old in Collaborative Pediatric Critical Care Research Network intensive care units with chest compressions for ≥1 minute and invasive arterial blood pressure monitoring prior to and during CPR between July 1, 2013 and June 31, 2016 were included...
December 26, 2017: Circulation
https://www.readbyqxmd.com/read/29249074/prognostic-factors-of-acute-neurological-outcomes-in-infants-with-traumatic-brain-injury
#5
Shunsuke Amagasa, Satoshi Tsuji, Hikoro Matsui, Satoko Uematsu, Takashi Moriya, Kosaku Kinoshita
PURPOSE: The purpose of this study is to clarify risk factors for poor neurological outcomes and distinctive characteristics in infants with traumatic brain injury. METHODS: The study retrospectively reviewed data of 166 infants with traumatic intracranial hemorrhage from three tertiary institutions in Japan between 2002 and 2013. Univariate and multivariate analyses were used to identify clinical symptoms, vital signs, physical findings, and computed tomography findings associated with poor neurological outcomes at discharge from the intensive care unit...
December 16, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/29242417/phase-changing-material-for-therapeutic-hypothermia-in-neonates-with-hypoxic-ischemic-encephalopathy-a-multi-centric-study
#6
Niranjan Thomas, Thangaraj Abiramalatha, Vishnu Bhat, Manoj Varanattu, Suman Rao, Sanjay Wazir, Leslie Lewis, Umamaheswari Balakrishnan, Srinivas Murki, Jaikrishnan Mittal, Ashish Dongara, Y N Prashantha, Somashekhar Nimbalkar
OBJECTIVE: To assess the feasibility and safety of cooling asphyxiated neonates using phase changing material based device across different neonatal intensive care units in India. DESIGN: Multi-centric uncontrolled clinical trial. SETTING: 11 level 3 neonatal units in India from November 2014 to December 2015. PARTICIPANTS: 103 newborn infants with perinatal asphyxia, satisfying pre-defined criteria for therapeutic hypothermia...
December 14, 2017: Indian Pediatrics
https://www.readbyqxmd.com/read/29224235/long-term-cardiovascular-re-programming-by-short-term-perinatal-exposure-to-nicotine-s-main-metabolite-cotinine
#7
Stefano Bastianini, Viviana Lo Martire, Alessandro Silvani, Giovanna Zoccoli, Chiara Berteotti, Hugo Lagercrantz, Anders Arner, Gary Cohen
AIM: Gather "proof-of-concept" evidence of the adverse developmental potential of cotinine (a seemingly benign biomarker of recent nicotine / tobacco smoke exposure). METHODS: Pregnant C57 mice drank nicotine or cotinine-laced water for 6wks from conception (NPRE = 2% saccharin+100μg nicotine/ml; CPRE = 2% saccharin + 10μg cotinine/ml) or 3wks after birth (CPOST = 2% saccharin + 30μg cotinine/ml). Controls drank 2% saccharin (CTRL). At 17±1weeks (male pups; CTRL n=6; CPOST n=6; CPRE n=8; NPRE n=9) we assessed (i) cardiovascular control during sleep; (ii) arterial reactivity ex vivo; (iii) expression of genes involved in arterial constriction / dilation...
December 9, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/29209510/milrinone-in-congenital-diaphragmatic-hernia-a-randomized-pilot-trial-study-protocol-review-of-literature-and-survey-of-current-practices
#8
REVIEW
Satyan Lakshminrusimha, Martin Keszler, Haresh Kirpalani, Krisa Van Meurs, Patricia Chess, Namasivayam Ambalavanan, Bradley Yoder, Maria V Fraga, Holly Hedrick, Kevin P Lally, Leif Nelin, Michael Cotten, Jonathan Klein, Stephanie Guilford, Ashley Williams, Aasma Chaudhary, Marie Gantz, Jenna Gabrio, Dhuly Chowdhury, Kristin Zaterka-Baxter, Abhik Das, Rosemary D Higgins
Background: Congenital diaphragmatic hernia (CDH) is commonly associated with pulmonary hypoplasia and pulmonary hypertension (PH). PH associated with CDH (CDH-PH) is frequently resistant to conventional pulmonary vasodilator therapy including inhaled nitric oxide (iNO) possibly due to right and left ventricular dysfunction. Milrinone is an intravenous inotrope and lusitrope with pulmonary vasodilator properties and has been shown anecdotally to improve oxygenation in PH. We developed this pilot study to determine if milrinone infusion would improve oxygenation in neonates ≥36 weeks postmenstrual age (PMA) with CDH...
2017: Maternal Health, Neonatology and Perinatology
https://www.readbyqxmd.com/read/29152464/intensivist-based-deep-sedation-using-propofol-for-pediatric-outpatient-flexible-bronchoscopy
#9
Kamal Abulebda, Samer Abu-Sultaneh, Sheikh Sohail Ahmed, Elizabeth A S Moser, Renee C McKinney, Riad Lutfi
AIM: To evaluate the safety and efficacy of sedating pediatric patients for outpatient flexible bronchoscopy. METHODS: A retrospective chart review was conducted for all children, age 17 years or under who underwent flexible bronchoscopy under deep sedation in an outpatient hospital-based setting. Two sedation regimens were used; propofol only or ketamine prior to propofol. Patients were divided into three age groups; infants (less than 12 mo), toddlers (1-3 years) and children (4-17 years)...
November 4, 2017: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29079904/neonatal-gastric-perforations-in-very-low-birth-weight-infants-a-single-center-experience-and-review-of-the-literature
#10
Aslan Babayigit, Seyithan Ozaydın, Merih Cetinkaya, Serdar Sander
PURPOSE: Gastric perforation is a rare condition with high mortality rates in preterm infants. The aim of this retrospective study was to define the risk factors and prognosis in very low birth weight (VLBW) infants with gastric perforations. METHODS: VLBW infants with a diagnosis of gastric perforation between 2012 and 2016 were included. The data including birth weight, gestational age, gender, risk factors, time and location of the perforation and prognosis were recorded...
October 27, 2017: Pediatric Surgery International
https://www.readbyqxmd.com/read/29063585/early-8-days-systemic-postnatal-corticosteroids-for-prevention-of-bronchopulmonary-dysplasia-in-preterm-infants
#11
REVIEW
Lex W Doyle, Jeanie L Cheong, Richard A Ehrenkranz, Henry L Halliday
BACKGROUND: Bronchopulmonary dysplasia remains a major problem in neonatal intensive care units. Persistent inflammation in the lungs is the most likely underlying pathogenesis. Corticosteroids have been used to prevent or treat bronchopulmonary dysplasia because of their potent anti-inflammatory effects. OBJECTIVES: To examine the relative benefits and adverse effects of systemic postnatal corticosteroids commenced within the first seven days of life for preterm infants at risk of developing bronchopulmonary dysplasia...
October 24, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29060766/modelling-interactions-between-blood-pressure-and-brain-activity-in-preterm-neonates
#12
Oksana Semenova, Gordon Lightbody, John M O'Toole, Geraldine Boylan, Eugene Dempsey, Andriy Temko
Hypotension or low blood pressure (BP) is a common problem in preterm neonates and has been associated with adverse short and long-term outcomes. Deciding when and whether to treat hypotension relies on an understanding of the relations between blood pressure and brain function. This study aims to investigate the interaction between BP and multichannel EEG in preterm infants less than 32 weeks gestational age. The mutual information is chosen to model interaction. This measure is independent of absolute values of BP and electroencephalography (EEG) power and quantifies the level of coupling between the short-term dynamics in both signals...
July 2017: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/29046318/central-serotonin-and-the-control-of-arterial-blood-pressure-and-heart-rate-in-infant-rats-influence-of-sleep-state-and-sex
#13
Jennifer L Magnusson, Kevin James Cummings
Sudden Infant Death Syndrome (SIDS) is associated with serotonin (5-HT) neuron abnormalities. There is evidence of autonomic dysfunction during sleep in infants eventually succumbing to SIDS, as well as cardiovascular collapse prior to death. Neonatal rodents deficient in central 5-HT display hypotension and bradycardia. We hypothesized that central 5-HT reduces cardiac vagal tone and increases sympathetic vascular tone and, given the firing pattern of 5-HT neurons, that these effects are greater in quiet sleep (QS) than in active sleep (AS)...
October 18, 2017: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
https://www.readbyqxmd.com/read/29035309/serum-magnesium-levels-in-preterm-infants-are-higher-than-adult-levels-a-systematic-literature-review-and-meta-analysis
#14
REVIEW
Jacques Rigo, Catherine Pieltain, Viola Christmann, Francesco Bonsante, Sissel J Moltu, Silvia Iacobelli, Stéphane Marret
Magnesium (Mg) is an essential mineral in the body, impacting the synthesis of biomacromolecules, bone matrix development, energy production, as well as heart, nerve, and muscle function. Although the importance of Mg is evident, reference values for serum Mg (sMg) in pediatric patients (more specifically, in neonates) are not well established. This systematic literature review and meta-analysis (using 47 eligible studies) aims to quantify normal and tolerable ranges of sMg concentrations during the neonatal period and to highlight the factors influencing Mg levels and the importance of regulating sMg levels during pregnancy and birth...
October 16, 2017: Nutrients
https://www.readbyqxmd.com/read/29033349/a-polymorphism-in-the-glucocorticoid-receptor-gene-is-associated-with-refractory-hypotension-in-premature-infants
#15
Kei Ogasawara, Maki Sato, Koichi Hashimoto, Takashi Imamura, Hayato Go, Mitsuaki Hosoya
BACKGROUND: Glucocorticoids play an important role in endocrine control. The association of glucocorticoid receptor (GR) gene polymorphisms with altered sensitivity to glucocorticoid therapy has been reported in adults. However, there are few such reports in infants. The present study analyzed the prevalence of four GR polymorphisms in preterm infants born before 30 weeks of gestation and determined the associations between these polymorphisms and clinical outcomes in the infants. METHODS: Totally, 41 preterm infants born at two hospitals in Fukushima were retrospectively screened for the presence of four GR gene polymorphisms, using a TaqMan single-nucleotide polymorphism genotyping assay...
September 27, 2017: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/28992392/norepinephrine-infusion-improves-haemodynamics-in-the-preterm-infants-during-septic-shock
#16
M Y Rizk, A Lapointe, F Lefebvre, K J Barrington
AIM: This study evaluated the clinical and haemodynamic effects of norepinephrine infusion in preterm infants. METHODS: The effects of norepinephrine therapy for refractory hypotension were evaluated in preterm infants between April 2009 and April 2011 at the neonatal intensive care unit of Sainte-Justine Hospital, Montreal, Quebec. Changes in haemodynamics and clinical parameters were analysed eight hours before and eight hours after the start of norepinephrine infusion, and eight hours after its cessation...
October 9, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28987396/use-of-nicardipine-after-cardiac-operations-is-safe-in-children-regardless-of-age
#17
Matthew L Stone, John Kelly, Maanasi Mistry, Marcia Buck, James Gangemi, Jeffrey Vergales
BACKGROUND: Control of postoperative hypertension is central to the care of infants and children after cardiac operations. Continuous pharmacologic delivery affords the advantage of rapid onset and ease of titration. Although well established in older children and adults, calcium channel blockers are routinely avoided in children aged younger than 1 year secondary to concerns of safety and efficacy in the setting of sarcoplasmic reticulum development. Thus, the purpose of this study was to review a single-institution experience with nicardipine, a selective calcium channel blocker, in pediatric patients after cardiac operations...
October 4, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28974135/propofol-and-fentanyl-sedation-for-laser-treatment-of-retinopathy-of-prematurity-to-avoid-intubation
#18
Fiammetta Piersigilli, Alessandra Di Pede, Gino Catena, Simona Lozzi, Cinzia Auriti, Iliana Bersani, Irma Capolupo, Anna Lipreri, Vincenzo Di Ciommo, Andrea Dotta, Stefania Sgrò
BACKGROUND: Despite the optimization of neonatal assistance, severe retinopathy of prematurity (ROP, stage III-IV) remains a common condition among preterm infants. Laser photocoagulation usually requires general anesthesia and intubation, but extubation can be difficult and these infants often affected by chronic lung disease. We retrospectively evaluated the clinical charts of 13 neonates that were sedated with propofol in association with fentanyl for the laser treatment of ROP. This protocol was introduced in our unit to avoid intubation and minimize side effects of anesthesia and ventilation...
October 3, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28953494/the-effect-of-prophylactic-phenylephrine-and-ephedrine-infusions-on-umbilical-artery-blood-ph-in-women-with-preeclampsia-undergoing-cesarean-delivery-with-spinal-anesthesia-a-randomized-double-blind-trial
#19
Nicole Higgins, Paul C Fitzgerald, Dominique van Dyk, Robert A Dyer, Natalie Rodriguez, Robert J McCarthy, Cynthia A Wong
BACKGROUND: Spinal anesthesia for cesarean delivery is associated with a high incidence of hypotension. Phenylephrine results in higher umbilical artery pH than ephedrine when used to prevent or treat hypotension in healthy women. We hypothesized that phenylephrine compared to ephedrine would result in higher umbilical artery pH in women with preeclampsia undergoing cesarean delivery with spinal anesthesia. METHODS: This study was a randomized double-blind clinical trial...
September 25, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28942689/fetal-inflammatory-response-syndrome-firs-and-outcome-of-preterm-neonates-a-prospective-analytical-study
#20
Febi Francis, Vishnu Bhat, Nivedita Mondal, Bethou Adhisivam, Sajini Jacob, Gowri Dorairajan, B N Harish
OBJECTIVES: To estimate the incidence of fetal inflammatory response syndrome (FIRS) in preterm neonates and correlate it with immediate and one-year neurodevelopmental outcome. MATERIALS AND METHODS: This prospective observational analytical study, in preterm neonates with gestational age between 26 and 34 weeks was conducted from May 2014 to December 2015 in a tertiary care hospital in South India. FIRS was defined as the presence of either elevated levels of interleukin-6 (IL-6) in cord blood ≥11 pg/ml and/or the placental histopathology showing evidence of fetal inflammatory response...
October 11, 2017: Journal of Maternal-fetal & Neonatal Medicine
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